Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -

Sung Kwan Hwang; Dong Hyun Kang; Tae Yeon Cho; Chang Ho Yi

doi:10.5371/jkhs.2010.22.3.209

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Hwang, Kang, Cho, and Yi: Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(3): 209-215.

Published online: 30 September 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.3.209

Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -

Sung Kwan Hwang, MD, PhD, Dong Hyun Kang, MD, Tae Yeon Cho, MD, Chang Ho Yi, MD

Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea.

Address reprint request to Sung Kwan Hwang MD, Ph.D. Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University, 162 Ilsan-dong,Wonju 220-701, Korea. TEL: +82-33-741-1351, FAX: +82-33-746-7326, hwtonlka@yonsei.ac.kr

Received 23 February 2010 Revised 15 June 2010 Accepted 16 June 2010

Abstract

Purpose

The purpose of this study was to evaluate the usefulness of bipolar hemiarthroplasty using a cemented femoral stem for treating femoral trochanteric region hip fractures in elderly patients.

Materials and Methods

This study includes 47 hips were available to be follow up for over 2 years, between December 1995 and December 2002. Clinical evaluation was done using Koval's classification before the fracture and at last follow-up, and Harris's hip score at the last follow up. Radiological evaluation was done via the plain radiographs.

Results

The Koval classification was as follows: recovery to the condition before fracture in 15 cases (31.9%), degradation by 1 class in 31 cases (66.0%) and degradation by 2 classes in 1 case (2.1%). The Harris hip score was 84.6 points at the last follow-up. All the cases showed stable fixation of the femoral stem. Postoperative complications were reported as 1 case of pneumonia, 1 case of deep vein thrombosis, 1 case of pulmonary thromboembolism, 1 case of pulmonary edema, 3 cases of stress ulcer, 1 case of superficial infection and 1 case of deep infection. Superficial pressure sore occurred in 1 case, postoperative delirium occurred in 9 cases and partial rupture of the bladder in 1 case.

Conclusion

Bipolar hemiarthroplasty using a cemented femoral stem was effective and satisfactory for the treatment of elderly patients with intertrochanter fractures. But further studies that will focus on complications are required.

Keywords: Intertrochanter fracture, Cemented stem, Bipolar hemiarthroplasty

Figures and Tables

Fig. 1

(A) Preoperative radiograph of a 84 years old female shows intertrochanter fracture. (B) Immediate postoperative radiograph shows stable stem fixation.(Kelley Grade A) (C) Post operative 2 years radiograph shows stable fixation.

Fig. 2

(A) Preoperative radiograph of a 81 years old male shows comminuted intertrochanter fracture. (B) Immediate postoperative radiograph shows that femoral stem was fixed well inside the medullary canal.(But Kelley Grade C) (C) Post operative 2 years radiograph shows radiolucent line on Gruen zone VI, VII but, Stable fixation was noted.

Table 1

Walking Ability by Koval

^**Categories of Walking Ability by Koval

^*1) Independent Community Ambulator, ^†2) Community Ambulator with Cane, ^‡3) Community Ambulator with Walker/Crutches ^§4) Independent Household Ambulator, ^∥5) Household Ambulator with Cane ,^¶6) Household Ambulator with Walker/Crutches ^**7) Nonfunctional Ambulator

Table 2

Summary of Radiological Analysis

Table 3

The Complications after Bipolar Hemiarthroplasty Using Cemented Femoral Stem

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