Cemented bipolar hemiarthroplasty in the management of comminuted intertrochanteric fracture of femur in elderly

Abstract

The management of comminuted intertrochanteric fractures in elderly is challenging because of difficult anatomical reduction, poor bone quality, and sometimes a need to protect the fracture from stresses of weight bearing and the need for early mobilization. Internal fixation in these cases usually involves prolonged bed rest or limited ambulation, to prevent implant failure. 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 analyze the role of primary cemented bipolar hemiarthroplasty in cases of comminuted intertrochanteric femur fractures. Fifty patients with comminuted intertrochanteric fractures were treated with primary cemented bipolar hemiarthroplasty. There were 31 females and 19 males with a mean age of 73.98 years (range, 65-89 years). The average surgery time was 101.86 mins (rang, 80-120 min). The patients walked on an average 4 days after surgery (range, 1-21 days). One patient had superficial skin infection and one had bed sore with no other significant postoperative complications. One case had DVT which was managed by close monitoring and conservative management in ICU setup. One patient had pulmonary embolism as result of cementing which was managed by intensive care in ICU setup. Eventually all patients recovered well and progressed to full weight bearing. A total of 48 out of 50 patients (96%) had excellent to fair functional results and 2 had poor result with respect to the Harris hip score (67-93) at the end of 6 months. Cemented bipolar hemiarthroplasty for comminuted intertrochanteric fractures in elderly patients results in early ambulation and good functional results.