Hip Pelvis.  2013 Sep;25(3):203-210. 10.5371/hp.2013.25.3.203.

Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Femoral Fracture in Elderly Patients

• Kho D
• Nam K
• Kang D
• Kim H

• KMID: 1974376
• DOI: http://doi.org/10.5371/hp.2013.25.3.203

Abstract

PURPOSE
The purpose of this study is to evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for comminuted intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
Between March 1998 and March 2008, the clinical records of 79 cases who were older than 75 years of age and underwent bipolar hemiarthroplaty, using calcar replacement stem with figure of eight and cerclage wiring, were reviewed. Their mean age was 82.4 years(75-92 years) and the mean follow-up period was 68 months(24-92 months).
RESULTS
The mean postoperative Harris hip score was 82.1(62-92), and preoperative walking ability was recovered in 56 cases(71%). Bony ingrowth fixation was achieved in 70 cases(89%), and fibrous stable fixation was in 9 cases(11%). Stress shields were revealed in 21 cases(27%). Nonunion of trochanter was found in 3 cases(4%), and wire fixation breakages were in 3 cases after bony union. The mean duration of bony union was 16.3 weeks(12-38 weeks). Aseptic loosening was observed in 1 case and protrusio acetabuli were in 2 cases.
CONCLUSION
The result of clinical and radiological evaluations of bipolar hemiarthroplasty, using calcar replacement stem with figure of eight and cerclage wiring, were satisfactory in elderly patients with comminuted intertrochanteric fracture.

Keyword

Unstable intertrochanteric fracture; Calcar replacement stem; Figure of eight and cerclage wiring; Bipolar hemiarthroplasty

MeSH Terms

Aged*
Femur
Follow-Up Studies
Hemiarthroplasty*
Hip
Hip Fractures*
Humans
Walking

Figure

• 

  Fig. 1 (A) Left anteroposterior lateral radiography of 77-year-old male patient shows A2 femoral intertrochanteric fracture. (B) Postoperative radiograph shows calcar replacement stem is tightly fitted after bipolar hemiarthroplasty with eight figure & cerclage wiring. (C) After 26 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with figure of eight and cerclage wiring.

• 

  Fig. 2 (A) Right hip anteroposterior and lateral radiography of 81-year-old female patient shows A2 femoral intertrochanteric fracture. (B) Postoperative radiograph shows calcar replacement stem is tightly fitted after bipolar hemiarthroplasty with eight figure & cerclage wiring. (C) Postoperative 24 month follow up radiograph shows no position change or subsidence of the stem and bony union of greater and lesser trochanter.

• 

  Fig. 3 Left hip anteroposterior of 82-year-old female patient shows a aseptic loosening and prutrusio acetabuli.

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