Treatment of Unstable Intertrochanteric Fracture with Bipolar Hemiarthroplasty of Hip in Elderly Population-Short-term Results-

Gun Woo Lee; Jae-Man Kwak; So Hak Chung

doi:10.7180/kmj.2012.27.1.37

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Lee, Kwak, and Chung: Treatment of Unstable Intertrochanteric Fracture with Bipolar Hemiarthroplasty of Hip in Elderly Population-Short-term Results-

Original Article

Kosin Medical Journal

Kosin Medical Journal 2012; 27(1): 37-43.

Published online: 11 June 2012

DOI: https://doi.org/10.7180/kmj.2012.27.1.37

Treatment of Unstable Intertrochanteric Fracture with Bipolar Hemiarthroplasty of Hip in Elderly Population-Short-term Results-

Gun Woo Lee, Jae-Man Kwak, So Hak Chung

Department of Orthopedic Surgery, College of Medicine, Kosin University, Busan, Korea.

Corresponding Author: So Hak Chung, Department of Orthopaedic Surgery, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu 602-702 Busan, Korea. TEL: 051) 990-6237, FAX: 051) 243-0181, shchung@kosin.ac.kr

Received 18 October 2011 Revised 24 March 2012 Accepted 30 April 2012

Abstract

Objectives

The aim of this study is to evaluate the short-term results and complications of treating the intertrochanteric fracture with bipolar hemiarthroplasty (BHA) in elderly population.

Methods

We retrospectively reviewed 31 unstable intertrochanteric fracture patients who were treated with BHA between January 2007 and August 2009 in older populations more than 65 years old. The 6 males and 25 females had a mean age of 79.8 years (range: 66-88) and a mean follow-up of 36.3 months (range: 24-55). We analyzed the radiological outcomes, functional recovery grade, using Jensen's social function score and Harris hip score (HHS), and complications.

Results

The average operation time and blood loss was 148.9 min (range, 110-215 min) and 455.2 mL (range, 200-1200 mL). Mean preoperative and postoperative hemoglobin (Hb) was 10.9 g/dL (range, 8.6-13.4 g/dL) and 10.5 g/dL (range, 5.1-14.1 g/dL) respectively. Average 1.3 pints of blood transfusion was performed. Ambulation with (or without) crutch was possible at mean 6.8 days postoperatively. The stability and alignment indices were adequate in all cases at final follow-up. On clinical results, the average HHS score, was changed from 79.7 points (range, 44-100) preoperatively to 73.0 points (range, 46-92) postoperatively, and the preoperative and postoperative Jensen's score was 1.8 (range, 1-3) and 2.1 (range, 1-4) respectively.

Conclusions

The BHA is an acceptable alternative for unstable intertrochanteric fractures in older population.

Keywords: Bipolar hemiarthroplasty, Femur, Unstable Intertrochanteric fracture

Figures and Tables

Fig. 1

(A) Pelvic radiograph showed the unstable intertrochanteric fracture of right femur. (B) On postoperative radiograph, well-fixed and aligned stem and cup was seen. (C) At 28 months postoperatively, radiolucent line of zone 1 was noted between cement and cortex. However, stem stability was maintained.

Table 1

The assessment of social function of Jensen

Table 2

Summarized data of patients about operative, functional outcomes and complications

HHS: Harris hip score, El: Elective, EM: Emergency.

Table 3

Published literature regarding treatment methods

BHA: Bipolar hemiarthroplasty, PFN: Proximal femoral nail, D/L: Dislocation.

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