Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Femoral Fracture in Elderly Patients

Dukhwan Kho; Kyoungmo Nam; Daemyung Kang; Hyeungjune Kim

doi:10.5371/hp.2013.25.3.203

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Kho, Nam, Kang, and Kim: Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Femoral Fracture in Elderly Patients

Original Article

Hip & Pelvis 2013; 25(3): 203-210.

Published online: 30 September 2013

DOI: https://doi.org/10.5371/hp.2013.25.3.203

Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Femoral Fracture in Elderly Patients

Dukhwan Kho, MD, Kyoungmo Nam, MD, Daemyung Kang, MD, Hyeungjune Kim, MD

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

Address reprint request to Hyeungjune Kim, MD. Department of Orthopedic Surgery, College of Medicine, Konkuk University, 620-5 Gyohyun-dong, Chungju 380-704, Korea. TEL: +82-43-840-8250, FAX: +82-43-844-7300, hjune7610@naver.com

Received 28 March 2013 Revised 23 August 2013 Accepted 30 August 2013

(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

The purpose of this study is to evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for comminuted intertrochanteric fracture in elderly patients.

Materials and Methods

Between March 1998 and March 2008, the clinical records of 79 cases who were older than 75 years of age and underwent bipolar hemiarthroplaty, using calcar replacement stem with figure of eight and cerclage wiring, were reviewed. Their mean age was 82.4 years(75-92 years) and the mean follow-up period was 68 months(24-92 months).

Results

The mean postoperative Harris hip score was 82.1(62-92), and preoperative walking ability was recovered in 56 cases(71%). Bony ingrowth fixation was achieved in 70 cases(89%), and fibrous stable fixation was in 9 cases(11%). Stress shields were revealed in 21 cases(27%). Nonunion of trochanter was found in 3 cases(4%), and wire fixation breakages were in 3 cases after bony union. The mean duration of bony union was 16.3 weeks(12-38 weeks). Aseptic loosening was observed in 1 case and protrusio acetabuli were in 2 cases.

Conclusion

The result of clinical and radiological evaluations of bipolar hemiarthroplasty, using calcar replacement stem with figure of eight and cerclage wiring, were satisfactory in elderly patients with comminuted intertrochanteric fracture.

Keywords: Unstable intertrochanteric fracture, Calcar replacement stem, Figure of eight and cerclage wiring, Bipolar hemiarthroplasty

Figures and Tables

Fig. 1

(A) Left anteroposterior lateral radiography of 77-year-old male patient shows A2 femoral intertrochanteric fracture. (B) Postoperative radiograph shows calcar replacement stem is tightly fitted after bipolar hemiarthroplasty with eight figure & cerclage wiring. (C) After 26 months follow up, bony union has been achieved and the stem is tightly fitted after bipolar hemiarthroplasty with figure of eight and cerclage wiring.

Fig. 2

(A) Right hip anteroposterior and lateral radiography of 81-year-old female patient shows A2 femoral intertrochanteric fracture. (B) Postoperative radiograph shows calcar replacement stem is tightly fitted after bipolar hemiarthroplasty with eight figure & cerclage wiring. (C) Postoperative 24 month follow up radiograph shows no position change or subsidence of the stem and bony union of greater and lesser trochanter.

Fig. 3

Left hip anteroposterior of 82-year-old female patient shows a aseptic loosening and prutrusio acetabuli.

Table 1

Modified Harris Hip Score^*

^*The score is multiplied by 1.1 to give an assessment out of 100.

Table 2

Clawson's Ambulation Capacity Classification

Table 3

Postoperative Complication

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