A Study of Management of Unstable Intertrochanteric Fractures and Basal Fractures of Neck of Femur in Elderly by Hemi-arthroplasty.

ABSTRACT

Background: Fractures of neck of femur are a major cause of morbidity and mortality in elderly population. Intertrochanteric fractures in elderly people are usually comminuted and unstable because of osteoporosis. Unstable intertrochanteric fractures in elderly patients are associated with high rates of morbidity and mortality2 although the results have improved with the use of Bipolar Hemi-Arthroplasty. Methods: All the patients were selected from among the admissions in the Department of Orthopaedics, MNR Medical college and hospital, Mediciti institute of medical sciences, Archana hospital, Hyderabad, from june 2013 to 2015 May. Cemented bipolar hemiarthroplasty (Non modular bipolar hip prosthesis of OSIM) with or without greater and lesser trochanter fixation by tension band wiring was done. The follow up was carried out at 6 weeks, 3 months, 6 months, and 1 year. The results were evaluated using Harris Hip Score Rating. Results: The average age of patients in our series was 65 years with a range of 60 years to 75 years. Out of 70 patients 42 (60%) were female and 28 (40%) male. Left side is more commonly involved with 38 patients (54%) than right side (46%). The average duration of hospital stay was 10 days, with a range of 10-25 days. Out of 70 patients 35 (50%) had excellent outcome, 14(20%), 14(20%), 7(10%), had good fair and poor outcomes respectively. Conclusion: Cemented bipolar hemi-arthroplasty with anatomical reconstruction of trochanteric region preserves abductor mechanism thus allowing early mobilization, safe early weight bearing on the injured hip and had a relatively low rate of complications.