Abstract :
Background and Objective: Hip fractures among elderly are associated with a high mortality rate imposing considerable burdens to
healthcare systems. Given the age, underlying diseases and poor bone quality of these patients, hemiarthroplasty can be used with bipolar
prosthesis. This study aimed to evaluate the outcomes of bipolar hemiarthroplasty (BA) elderly patients with intertrochanteric fractures.
Materials and Methods: This study was conducted on 35 patients with unstable intertrochanteric fracture after surgery using cemented
bipolar hemiarthroplasty method. Three patients had incomplete follow-ups and five patients were deceased. In total, 27 patients (12 males
and 15 females) were followed up for a mean duration of 38.85 months (12-70 months). Clinical and radiographic evaluations were
performed. Subjects were assessed in terms of weight bearing, the ability to walk with or without assistance, evaluation of the amount of
limb length discrepancy, evaluation of deep infection, dislocation of the implant, claudication, pain during walking, presence of loosening
or subsidence prosthesis, acetabular erosion and nonunion of the greater trochanter. Harris Hip Score (HHS) questionnaire was filled for all
the patients. In addition, lack of the ability to walk and non-ambulatory or prosthesis subsidence were defined as failure of the surgery.
Results: At the end of the follow-up, the HHS score was excellent for five patients, whereas it was good, fair, and poor for 12, 6, and 4
patients, respectively. In addition, mean HHS was 81.22 (good). During the follow-up, 14 patients were able to walk without assistance and
pain, and 11 patients walked with assisting tools. There were no deep infection cases. In total, two cases of prosthesis dislocation, three
cases of loosening around stem, three patients with nonunion of the greater trochanter and three patients with limb length discrepancy
(LLD) less than 2cm were identified.
Conclusion: Performing surgery with cemented bipolar hemiarthroplasty method to treat patients with unstable intertrochanteric fracture
and osteoporotic led to acceptable clinical and functional results. Therefore, it is recommended that bipolar hemiarthroplasty method can
be used to help patients for accelerate to start walking, so that unwanted complications, such as non-ambulatory, are prevented.
Keyword :
ntertrochanteric fracture, bipolar hemiarthroplasty, Harris Hip Score