Results of primary hemireplacement arthroplasty in comminuted unstable fracture of intertrochanteric region in old age patients

Author(s): Dr. Rajnikant Machhi, Dr. Chirag B Patel and Dr. Vishal M Dindod

Abstract: A prospective study of 20 patients having comminuted unstable intertrochanteric fracture 31A2 according to AO classification treated with cemented bipolar was done between April 2008 to September 2010 at Sir T Hospital, Bhavnagar. We studied postoperative complications, mortality rate, functional outcome using Harris hip score and radiological evidence of healing. Average age of the patients was 84 years. Females outnumber males by a ratio of 3:1. 40% patients had associated medical illness. Average injury operation interval was 3.1 days. Final results were evaluated in 17 patients. 90% of patients were operated by modified Gibson’s approach. Mobilisation and weight bearing was started immediately in the postoperative period. Average time taken to return to normal daily activities was 31 days. Mortality rate was 10%. One patient died on the 5th postoperative days due to pulmonary embolus and renal failure. 1 patient died at one month due to IHD. 5% patient had dislocation. No loosening or infection of the implants was observed. 1 patient had superficial infection which was resolved with antibiotic. Functional outcome was evaluated with Harris hip score. Harris hip score was 79±5.31 (mean± standard deviation); at 3 months 81±5.47; at 6 months 84±4.68; at 1 year 85±3.83. This procedure offers good functional outcome, avoids complications associated with internal fixation and mechanical failure in old age osteoporotic patients.

DOI: https://doi.org/10.22271/ortho.2017.v3.i3b.12