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Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study

Introduction It is frequently challenging to treat an unstable intertrochanteric fracture in elderly people by internal fixation because of difficult anatomical reduction, poor bone quality, the need for prolonged bed rest and restricted ambulation. As an alternative to internal fixation, cemented b...

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Autores principales: Singh, Jasveer, Kumar, Dinesh, Kumar, Sunil, Mittal, Ankit, Gupta, Pradeep Kumar, Rajput, Ajay Kumar, Kant, Ravi, Singh, Santosh Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839356/
https://www.ncbi.nlm.nih.gov/pubmed/36654573
http://dx.doi.org/10.7759/cureus.32526
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author Singh, Jasveer
Kumar, Dinesh
Kumar, Sunil
Mittal, Ankit
Gupta, Pradeep Kumar
Rajput, Ajay Kumar
Kant, Ravi
Singh, Santosh Kumar
author_facet Singh, Jasveer
Kumar, Dinesh
Kumar, Sunil
Mittal, Ankit
Gupta, Pradeep Kumar
Rajput, Ajay Kumar
Kant, Ravi
Singh, Santosh Kumar
author_sort Singh, Jasveer
collection PubMed
description Introduction It is frequently challenging to treat an unstable intertrochanteric fracture in elderly people by internal fixation because of difficult anatomical reduction, poor bone quality, the need for prolonged bed rest and restricted ambulation. As an alternative to internal fixation, cemented bipolar hemiarthroplasty has been used as a treatment for unstable intertrochanteric fractures to avoid the postoperative immobilization-related complications. The aim of this study was to evaluate the functional and clinical outcomes of primary cemented bipolar hemiarthroplasty for elderly patients with unstable intertrochanteric fractures. Methodology A prospective study was conducted that included 30 patients who were admitted to the apex trauma center at a tertiary care center from January 2019 to August 2020 with unstable intertrochanteric fractures (Association for Osteosynthesis/Orthopaedic Trauma Association, or AO/OTA, types 31-A2.2 and 31-A2.3); patients treated with cemented bipolar hemiarthroplasty, with at least one year of follow-up were included in the study. Basic descriptive statistics were used and the results were presented in frequencies, percentages for categorical variables and means and standard deviations for continuous variables. Results According to the Harris Hip Score, at the end of 12 months, 9 patients (30%) had excellent results, 14 patients (46.67%) had good results, 5 patients (16.67) had fair results, and 2 cases (6.67) had poor results. With cemented hemiarthroplasty, 87.7% of older patients with unstable intertrochanteric fractures were able to walk sooner, and the results were good. Conclusion Hemiarthroplasty of the hip with a cemented bipolar prosthesis appears to be a reliable treatment method for the management of unstable intertrochanteric fractures in elderly patients with osteoporosis; it allows for early ambulation and leads to a favorable functional outcome in most patients following surgery.
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spelling pubmed-98393562023-01-17 Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study Singh, Jasveer Kumar, Dinesh Kumar, Sunil Mittal, Ankit Gupta, Pradeep Kumar Rajput, Ajay Kumar Kant, Ravi Singh, Santosh Kumar Cureus Orthopedics Introduction It is frequently challenging to treat an unstable intertrochanteric fracture in elderly people by internal fixation because of difficult anatomical reduction, poor bone quality, the need for prolonged bed rest and restricted ambulation. As an alternative to internal fixation, cemented bipolar hemiarthroplasty has been used as a treatment for unstable intertrochanteric fractures to avoid the postoperative immobilization-related complications. The aim of this study was to evaluate the functional and clinical outcomes of primary cemented bipolar hemiarthroplasty for elderly patients with unstable intertrochanteric fractures. Methodology A prospective study was conducted that included 30 patients who were admitted to the apex trauma center at a tertiary care center from January 2019 to August 2020 with unstable intertrochanteric fractures (Association for Osteosynthesis/Orthopaedic Trauma Association, or AO/OTA, types 31-A2.2 and 31-A2.3); patients treated with cemented bipolar hemiarthroplasty, with at least one year of follow-up were included in the study. Basic descriptive statistics were used and the results were presented in frequencies, percentages for categorical variables and means and standard deviations for continuous variables. Results According to the Harris Hip Score, at the end of 12 months, 9 patients (30%) had excellent results, 14 patients (46.67%) had good results, 5 patients (16.67) had fair results, and 2 cases (6.67) had poor results. With cemented hemiarthroplasty, 87.7% of older patients with unstable intertrochanteric fractures were able to walk sooner, and the results were good. Conclusion Hemiarthroplasty of the hip with a cemented bipolar prosthesis appears to be a reliable treatment method for the management of unstable intertrochanteric fractures in elderly patients with osteoporosis; it allows for early ambulation and leads to a favorable functional outcome in most patients following surgery. Cureus 2022-12-14 /pmc/articles/PMC9839356/ /pubmed/36654573 http://dx.doi.org/10.7759/cureus.32526 Text en Copyright © 2022, Singh et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Orthopedics
Singh, Jasveer
Kumar, Dinesh
Kumar, Sunil
Mittal, Ankit
Gupta, Pradeep Kumar
Rajput, Ajay Kumar
Kant, Ravi
Singh, Santosh Kumar
Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title_full Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title_fullStr Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title_full_unstemmed Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title_short Functional Outcome of Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures of the Femur in Elderly Patients: A Prospective Study
title_sort functional outcome of hemiarthroplasty of the hip for unstable intertrochanteric fractures of the femur in elderly patients: a prospective study
topic Orthopedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839356/
https://www.ncbi.nlm.nih.gov/pubmed/36654573
http://dx.doi.org/10.7759/cureus.32526
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