Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

Han-Jun Lee; Jong Won Kim; Jae-Sung Lee; Jae June Yang; Woo-Young Hwang

doi:10.12671/jkfs.2010.23.3.276

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Lee, Kim, Lee, Yang, and Hwang: Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(3): 276-281.

Published online: 31 July 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.3.276

Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

Han-Jun Lee, M.D., Jong Won Kim, M.D.^*, Jae-Sung Lee, M.D., Jae June Yang, M.D., Woo-Young Hwang, M.D.

Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

^*Department of Orthopedic Surgery, Hanil General Hospital, Seoul, Korea.

Address reprint requests to: Jong Won Kim, M.D. Department of Orthopedic Surgery, Hanil General Hospital, 388-1, Ssangmun-dong, Dobong-gu, Seoul 132-703, Korea. Tel: 82-2-901-3078, Fax: 82-2-900-1745, osjongwoni@hotmail.com

Received 9 April 2010 Revised 17 May 2010 Accepted 15 June 2010

(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 clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.

Materials and Methods

From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.

Results

The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.

Conclusion

In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.

Keywords: Unstable intertrochanteric fracture, Cementless bipolar hemiarthroplasty

Figures and Tables

Fig. 1

The displaced greater trochanteric fragments were fixed with non-absorbable suture material.

Fig. 2

The fragment of femoral neck replace the lesser trochanteric fragment with wiring.

Fig. 3

(A) Preoperative radiograph of a 71-year-old female shows unstable intertrochanteric fracture.

(B) Immediate postoperative radiograph shows bipolar arthroplasty state.

(C) Radiograph at postoperative 1 year shows stable fixation.

Table 1

The results of HHS^*, P&P score^†, fit of femoral stem and vertical subsidence

^*HHS: Harris hip score, ^†P&P score: Parker and Palmer mobility score.

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