J Korean Hip Soc.  2010 Sep;22(3):209-215. 10.5371/jkhs.2010.22.3.209.

Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients: Minimum 2-Years Follow-up Results

• Hwang SK
• Kang DH
• Cho TY
• Yi CH

• KMID: 1461172
• DOI: http://doi.org/10.5371/jkhs.2010.22.3.209

Abstract

PURPOSE
The purpose of this study was to evaluate the usefulness of bipolar hemiarthroplasty using a cemented femoral stem for treating femoral trochanteric region hip fractures in elderly patients.
MATERIALS AND METHODS
This study includes 47 hips were available to be follow up for over 2 years, between December 1995 and December 2002. Clinical evaluation was done using Koval's classification before the fracture and at last follow-up, and Harris's hip score at the last follow up. Radiological evaluation was done via the plain radiographs.
RESULTS
The Koval classification was as follows: recovery to the condition before fracture in 15 cases (31.9%), degradation by 1 class in 31 cases (66.0%) and degradation by 2 classes in 1 case (2.1%). The Harris hip score was 84.6 points at the last follow-up. All the cases showed stable fixation of the femoral stem. Postoperative complications were reported as 1 case of pneumonia, 1 case of deep vein thrombosis, 1 case of pulmonary thromboembolism, 1 case of pulmonary edema, 3 cases of stress ulcer, 1 case of superficial infection and 1 case of deep infection. Superficial pressure sore occurred in 1 case, postoperative delirium occurred in 9 cases and partial rupture of the bladder in 1 case.
CONCLUSION
Bipolar hemiarthroplasty using a cemented femoral stem was effective and satisfactory for the treatment of elderly patients with intertrochanter fractures. But further studies that will focus on complications are required.

Keyword

Intertrochanter fracture; Cemented stem; Bipolar hemiarthroplasty

MeSH Terms

Aged
Delirium
Femur
Follow-Up Studies
Hemiarthroplasty
Hip
Hip Fractures
Humans
Pneumonia
Postoperative Complications
Pressure Ulcer
Pulmonary Edema
Pulmonary Embolism
Rupture
Ulcer
Urinary Bladder
Venous Thrombosis

Figure

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  Fig. 1 (A) Preoperative radiograph of a 84 years old female shows intertrochanter fracture. (B) Immediate postoperative radiograph shows stable stem fixation.(Kelley Grade A) (C) Post operative 2 years radiograph shows stable fixation.

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  Fig. 2 (A) Preoperative radiograph of a 81 years old male shows comminuted intertrochanter fracture. (B) Immediate postoperative radiograph shows that femoral stem was fixed well inside the medullary canal.(But Kelley Grade C) (C) Post operative 2 years radiograph shows radiolucent line on Gruen zone VI, VII but, Stable fixation was noted.

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