Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly

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

doi:10.12671/jkfs.2009.22.4.239

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Kho, Kim, Kim, and Kim: Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly

Original Article

Journal of the Korean Fracture Society 2009; 22(4): 239-245.

Published online: 30 October 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.239

Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly

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

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

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

Received 2 March 2009 Revised 25 May 2009 Accepted 24 June 2009

(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 the treatment of femoral basicervical fractures aged 75 years or older.

Materials and Methods

We reviewed the clinical records of 60 patients who were older than 75 years and who underwent bipolar hemiarthroplasty for femoral basicervical fractures using calcar replacement stem between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability and modified Harris hip score, the activities of daily living, the associated medical conditions and arthritis, and postoperative disgnosis.

Results

The mean Harris hip score were 87.2 (74~92). Walking ability was recovered in 91% (55 cases) and activity of daily living was achived in 91% (55 cases). Press-fit fixations were 56 cases and bony ingrowth fixations were 57 cases. Stress shields were 28% (17 cases). Thigh pains were 5% (3 cases) and revision rate was 3% (2/60 cases).

Conclusion

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

Keywords: Elderly, Basiccervical fractures, Calcar replacement stem, Bipolar hemiarthroplasty

Figures and Tables

Fig. 1

Recovery of activity of daily life by Koval and Zukerman.

Fig. 2

A 80-year-old female with right hip pain.

(A) Preoperative radiograph showing a Garden stage IV basicervical femoral neck fracture.

(B) Postoperative radiograph after bipolar hemiarthroplasty using calcar replacement stem.

(C) Postoperative 36 month follow-up radiograph showing no position change or subsidence of the stem.

Table 1

Preoperative associated medical conditions

Table 2

Preoperative associated arthritis

Table 3

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

Table 4

Recovery of walking ability by hoffer

Table 5

Postoperative complication

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