Comparison of Functional Recovery between Internal Fixation and Hemiarthroplasty in Basal Intertrochanteric Fracture in the over Eighties

Yoon, Hyung Ku; Cho, Duck Yun; Shin, Dong Eun; Kang, Sung Hoon

Abstract

PURPOSE
To compare functional recovery and clinical outcome for internal fixation and hemiarthroplasty groups over eighty years old for basal intertrochanteric fracture. MATERIALS AND METHODS: Forty-two cases among 62 treated from Aug. 1997 to May 2001 (22 internal fixation-group A and 20 hemiarthroplasty-group B) were retrospectively evaluated to assess walking level, activity of daily living, mental status, dementia, chronic illness and complications after at least a one year follow up. RESULTS: Partial weight bearing was started at a postoperative 14.5 and 9.5 days and full weight bearing at 10 and 3 weeks in group A and B, respectively. Walking level changed from 3.5 to 2.2 in group A, from 3.0 to 2.5 in group B, and the daily living activity scale from 4.8 to 7.9, and from 4.6 to 6.2. Mental status reduced from 22.8 to 18.2, and from 22.8 to 19.7 in each group. Newly developed dementia occurred in 6 and 5, and the index of chronic illness increased from 2.09 to 2.27, and from 2.05 to 2.25 in each group. Other postoperative complications showed no significant difference between the groups. CONCLUSION: The authors suggest bipolar hemiarthroplasty shows better functional recovery in terms of walking level, activity of daily living, and mental status, but same recovery for dementia, postoperative delirium and chronic illness compared to the internal fixation group. Therefore, the authors suggest that bipolar hemiarthroplasty in an effective surgical method in the over eighties.