Hemi Replacement Arthroplasty for Unstable Inter-Trochanteric Fractures of Femur
Introduction: Unstable inter-trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut-out of the lag screw, are the common problems of attempts to fix these fractures. Present study is an attempt...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2014-10-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/4972/10171_CE(Ra)_F(Sh)_PF1(PAK)_PFA(Sh)_PFA2(AK).pdf |
Summary: | Introduction: Unstable inter-trochanteric fracture in the geriatric
population is a common injury and is associated with poor bone
quality, excessive collapse, loss of fixation, and cut-out of the
lag screw, are the common problems of attempts to fix these
fractures. Present study is an attempt to evaluate the functional
outcome of primary cemented bipolar hemiarthroplasty in
unstable inter-trochanteric fractures in elderly patients.
Materials and Methods: This prospective study included 25
cases with unstable inter-trochanteric fracture of femur between
60 -75 y of age in whom primary Cemented Bipolar hemi -
arthroplasty was performed. The patients were followed up at
six week, three month, six month and one year postoperatively
and assessed using Harris Hip Score (HHS), Lower Extremity
Functional Scale (LEFS), Visual analogue scale (VAS) for
evaluation of outcome.
Results: The mean HHS score was 78.86+8.13 by the end of
one year. Similarly mean LEFS score was 34.36+7.01 by the end
of one year, whereas the mean pain score on VAS Scale by the
year end was 1.04+1.02.
Discussion: The changes in HHS, LEFS and VAS up to six
months periods are much greater which starts showing a stable
trend thereafter. Fair to good scores were observed in all the
patients. We compared our results with those reported by other
authors and our study gave quite comparable results. We also
used lower extremity function status score (LEFS) for assessment
of functional ability. The purpose of its use was that while
Harris Hip Score (HHS) provides information on a multitude of
factors, LEFS is more patient oriented and provides the correct
information about the level of activities a patient can resume
post-operatively and can be offered as a self assessment tool.
No significant complication except for grade I pressure sores
in four patients were seen in postoperative period but they all
resolved with proper nursing care by six week follow up. No
patient required revision surgery.
Conclusion: The authors believe that primary cemented bipolar
hemiarthroplasty for unstable inter-trochanteric fractures of
femur in elderly does provide early ambulation, good functional
outcome, pain free joint with minimal complications without the
need for revision surgery. |
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ISSN: | 2249-782X 0973-709X |