Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -

Chae-Hyun Lim; Young-Yool Chung; Jeong-Seok Kim; Chung-Young Kim

doi:10.5371/hp.2013.25.1.44

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Lim, Chung, Kim, and Kim: Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -

Original Article

Hip & Pelvis

Hip & Pelvis 2013; 25(1): 44-50.

Published online: 31 March 2013

DOI: https://doi.org/10.5371/hp.2013.25.1.44

Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -

Chae-Hyun Lim, MD, Young-Yool Chung, MD, Jeong-Seok Kim, MD, Chung-Young Kim, MD

Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Address reprint request to Young-Yool Chung, MD. Department of Orthopedic Surgery, Kwangju Christian Hospital, 264 Yangrim-dong, Nam-gu, Gwangju 503-715, Korea. TEL: +82-62-650-5060, FAX: +82-62-650-5066, paedic@chol.com

Received 6 August 2012 Revised 9 January 2013 Accepted 10 January 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 investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old.

Materials and Methods

Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups.

Results

Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively.

Conclusion

Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly.

Keywords: Intertrochanteric fracture, Hip arthroplasty, Elderly patient, Relative surgical risk

Figures and Tables

Fig. 1

(A) M/L taper® prosthesis was used for femoral neck fracture and (B) Versys® beaded fullcoat collored femoral stem for intertrochanteric fracture.

Fig. 2

(A) Preoperative radiograph of 84 years old female with unstable intertrochanteric fracture in the right hip. (B) Cementless hemiarthroplasty was done after 3 days from injury. Wire & non-absorbable suture were used for fixation of greater and lesser trochanter. Ambulation using walker began 5 days after operation. (C) At last follow up, the patient restores the walking ability before injury without complication.

Table 1

Demographics of Two Groups

^*: Chronic Obstructive Pulmonary Disease, ^†: Congestive Heart Failure.

Table 2

Walking Ability

Table 3

Clinical Results of Two Groups

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