Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly

Duk-Hwan Kho; Ki-Hwan Kim; Hyeung-June Kim; Dong-Heon Kim

doi:10.12671/jkfs.2008.21.3.232

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Kho, Kim, Kim, and Kim: Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly

Original Article

Journal of the Korean Fracture Society 2008; 21(3): 232-239.

Published online: 31 July 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.3.232

Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly

Duk-Hwan Kho, M.D., Ki-Hwan Kim, M.D., Hyeung-June Kim, M.D., Dong-Heon Kim, M.D.

Department of Orthopedic Surgery, Konkuk University Chungju Hospital, College of Medicine, Konkuk University, Chungju, Korea.

Address reprint requests to: Dong-Heon Kim, M.D. Department of Orthopedic Surgery, Konkuk University Chungju Hospital, College of Medicine, Konkuk University, 620-5, Gyohyeondong, Chungju 380-704, Korea. Tel: 82-43-840-8251, Fax: 82-43-844-7300, kdkim@kku.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for hip fractures in elderly patients.

Materials and Methods

Between March 1995 and March 2005, the clinical records on 68 cases more than 75 years old who underwent the bipolar hemiarthroplasty using calcar replacement stem and followed minimum 2 years were reviewed. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, complications, osteoporosis and radiologic findings.

Results

The mean postoperative modified Harris hip score was 88.3 (69~95) in femoral neck fractures and 83.5 (63~91) in femoral intertrochanteric fractures. Walking ability was recovered in 82.3% (56 cases) and activity of daily living was achived in 82.3% (56 cases). Complications were thigh pain, infection, femoral stem subsidence, stress shield, dislocation.

Conclusion

We consider bipolar hemiarthroplasty using calcar replacement stem for unstable hip fractures in elderly patients with severe osteoporosis is the useful treatment in view of the stable and rigid fixation, early ambulation and the low rate of complications, even if the operation is technically very difficult.

Keywords: Elderly, Hip fracture, Calcar replacement stem, Bipolar hemiarthroplasty

Figures and Tables

Fig. 1

Recovery of activity of daily life.

Fig. 2

(A, B) Preoperative both hip anteroposterior and left hip lateral radiography of 88 year-old female patient shows Garden Type IV femur neck fracture.

(C, D) After 28 months follow up bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty using calcar replacement stem with figure of eight and cerclage wiring.

Fig. 3

(A, B) Preoperative both hip anteroposterior and right hip lateral radiography of 78 year-old female patient shows Evans unstable femur intertrochanteric fracture.

(C, D) After 14 months follow up bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty using calcar replacement stem with cerclage wiring and Dall-Miles cable.

Table 1

Type of hip fracture

Table 2

Modified Harris hip score. The score is multiplied by 1.1 to give an assessment out of 100

Table 3

Recovery of walking ability

Table 4

Osteoporosis by BMD and Singh index

Table 5

Postoperative complication

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