Role of arthroplasty in unstable trochanteric fractures in elderly patients

Abstract

Objective: Unstable intertrochanteric fractures in elderly patients pose a challenge for treatment in view of coexistent medical problems and osteoporosis. Osteosynthesis in these group of patients often leads to implant failure and also does not allow early weight bearing. The objective of the present study is evaluate Arthroplasty as primary treatment of choice in these unstable intertrochanteric fractures in elderly. Methods: Between January 2013 to Feb 2016, 25 elderly patients with unstable intertrochanteric fractures who had undergone arthroplasties (Hemi/THR) were followed up. Their fractures were classified according to the AO/OTA classification and their osteoporosis was evaluated by Singh’s index and graded accordingly. After optimization of medical problems and pre-anesthetic workup, Arthroplasty was performed in all patients and the outcomes analyzed using the Harris hip score system.Conclusion: In select elderly patients with unstable intertrochanteric fractures arthroplasty has a role instead of Osteosynthesis which allows early pain free mobilization of patients, thereby avoiding revision surgeries, prolonged morbidity and uncertainty associated with Osteosynthesis.