Evaluation of outcome of primary cemented hemiarthroplasty for intertrochanteric femur fracture in the elderly

Abstract

Introduction: Appropriate treatment method for osteoporotic trochanteric fracture in elderly people is rather controversial because of the poor quality of bone mass, difficult anatomical reduction and accompanying systemic disorders. Internal fixation in these cases usually involves prolonged bed rest, limited ambulation and implant failure secondary to osteoporosis. This might result in higher chances of complications like pulmonary embolism, deep vein thrombosis, pneumonia, and decubitus ulcer. The purpose of this study is to analyse the role of primary cemented hemiarthroplasty in cases of osteoporotic intertrochanteric femur fractures in elderly patients with co-morbities. Materials and Methods: In this study, 120 cases of primary cemented hemiarthroplasty performed for osteoporotic intertrochanteric fractures were analysed retrospectively. There were 85 female and 35 male. Mean age of the patients were 65.2 years (range, 60-85 years). Harris hip score (HHS) was used to assess the outcome. Result: The mean Harris hip score at the two-year follow-up was 83.10 ± 10.90. A total of 25 patients were graded as excellent, 60 patients as good, 30 as fair and 5 as poor. It was observed that, patients with stable variety of intertrochanteric fractures had better outcome than the unstable variety in our study. Conclusion: Hemiarthroplasty for osteoporotic intertrochanteric fractures in the elderly patient results in early ambulation and good functional results, although further prospective randomised trials are required before reaching to conclusion.