Primary Bipolar Arthroplasty in Unstable Intertrochanteric Fractures in Elderly

Ahmed Elmorsy, Mahmoud Saied, Mahmoud Zaied, Mahmoud Hafez

Orthopaedic Department, Alazhar University, Cairo, Egypt..
Orthopaedic Department, October 6 University, Cairo, Egypt.

DOI: 10.4236/ojo.2012.21003                

Abstract

Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the results of bipolar arthroplasty as an alternative to the standard treatment of internal fixation. Materials and methods: 41 patients (22 females and 19 males) who had bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Modified lateral approach was used in all patients. Clinical evaluation was done using Harris Hip Score (HHS) and radiological follow up was done using plain X-rays. All the patients were 65 years of age or above. Follow up period ranged from (12 - 24) months. Results: During the last follow up, the Harris Hip Score ranged from 93 to 51 with a mean value 78.19. Four cases (9.76%) were excellent (91 - 100), 16 cases (39.02%) good (81 - 90), 16 cases (39.02%) fair (71 - 80) and 5 cases (12.02%) poor (= or < 70). Six cases had complications; infection (1), dislocation (1), stem loosening and subsidence (2), bleeding peptic ulcer (1) and intra-operative crack of the femur while preparing the femoral canal for implant insertion (1). Five patients died within the first year (12.19%). Four patients had revision surgery. Conclusion: Bipolar hemiarthroplasty for the unstable intertrochanteric fractures of the femur in elderly has a reasonable clinical outcome at 2 years. It is to be considered as one of the treatment options for such injury speciality in case of fragility fractures.

Keywords

Bipolar; Unstable; Intertrochanteric Fractures; Hemiarthroplasty

Conflicts of Interest

The authors declare no conflicts of interest.

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