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ORIGINAL ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 2  |  Page : 81-86

Unstable intertrochanteric fracture in elderly treated with bipolar hemiarthroplasty: A prospective case series


1 Department of Orthopaedics, Victoria Hospital, B.M.C.R.I, Bengaluru, Karnataka, India
2 Department of Orthopaedics, Aarupadai Veedu Medical College and Hospital, Puducherry, India

Correspondence Address:
Dr. N Raghavendra Beshaj
Department of Orthopaedics, Aarupadai Veedu Medical College and Hospital, Puducherry - 607 402
India
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Source of Support: Funding by institution under Government of Karnataka, Conflict of Interest: None


DOI: 10.4103/1597-1112.154930

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Purpose: To evaluate functional results of bipolar hemiarthroplasty for unstable intertrochanteric fracture in elderly patient. Materials and Methods: Between 2005 and 2012 20 elderly patients more than 65 years with intertrochanteric fractures <3 weeks old, having associated medical comorbidities like diabetes mellitus, hypertension, chronic bronchitis and emphysema were included. And patients with open intertrochanteric fractures, poly-trauma, pathological fractures, and aged <65 years were excluded from study. Results: There were 11 male and 9 female patients with mean age of 78.1 years treated by cemented bipolar hemiarthroplasty. The average surgery time was 123 min with an average intraoperative blood loss of 431.5 ml. Eleven patients were transfused a pint of blood. Grade 1 bedsores in two patients healed with regular dressing, regular change of position and antibiotics. One patient developed deep wound infection for whom implant removal and excision arthroplasty was done. Limb length discrepancy was <1 cm in six patients. No case of dislocation, rotational deformities or subsidence of the prosthesis was seen during the follow-up. Functional results were graded as per Harris Hip Scoring System, mean Harris Hip Scorewas 78.2 at 6 months and 83.25 at 24 months. Conclusion: Careful restoration of neck length, offset and version maximizes the stability of the hip joint and increases the durability of the prosthesis which is very essential in achieving a good outcome. The procedure offered faster mobilization, rapid return to pre injury level and gave a lasting solution in elderly patients with intertrochanteric fractures of the femur. Level of Study: Level 4 case series.


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