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Cemented bipolar hemiarthroplasty for unstable intertrochanteric fracture in elderly patients over 70 years: Boon or bane?

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Abstract

Introduction

The surgical management of intertrochanter femur fracture in elderly patient is still under debate. Various implants can be utilised but prosthetic replacement is gaining popularity. This study was performed to evaluate the functional and clinical outcomes of cemented bipolar arthroplasty as a primary treatment for unstable intertrochanteric fracture in elderly patients (> 70 years).

Materials and methods

Thirty-seven patients with unstable intertrochanteric fracture in elderly patient (> 70 years) who underwent cemented bipolar hemiarthroplasty. Intra-operative and post-operative complications were noted; functional outcomes were assessed using Harris hip score (HHS). All patients were followed up for a minimum of 12 months.

Results

Overall 90% of patients has some minor or major intra or post-operative complication. One year mortality rate was 16% (6/37). Cardiopulmonary events were the most common life threatening incident. Mean fall in Haemoglobin was 1.6 gm/dL. The average time for full weight bearing mobilisation with the help of walker was 2.8 ± 1.2 days (1–8 days). The average duration of surgery was 58 ± 6 min (44–96 min) with an average blood loss of 126 ± 24 mL (90–380 mL). HHS at the end of 12 months was 77.

Conclusions

The use of bipolar hemiarthroplasty in senile patient with unstable hemiarthroplasty gives an advantage of early weight bearing. However, it is associated with risk of significant intra or post-operative morbidity due to intra-operative trauma, surgical time and blood loss during the surgery. Although hemiarthroplasty can be a single-time solution to the complexities of intertrochanter fracture in elderly patients but should be performed in selected patients only.

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No funding was received for this study.

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Authors and Affiliations

  1. Department of Orthopaedics, Indus Hospital, Mohali, India

    Bushu Harna

  2. Department of Orthopaedics, IVY Hospital, Mohali, India

    Anil Kapoor

  3. Department of Orthopaedics, Medical college Baroda and SSG Hospital, Vadodara, India

    Tarun Verma

  4. Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India

    Dhananjaya Sabat

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  1. Bushu Harna
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Correspondence to Anil Kapoor.

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Harna, B., Kapoor, A., Verma, T. et al. Cemented bipolar hemiarthroplasty for unstable intertrochanteric fracture in elderly patients over 70 years: Boon or bane?. Eur J Orthop Surg Traumatol 34, 1449–1456 (2024). https://doi.org/10.1007/s00590-023-03819-0

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