OUTCOMES ANALYSIS OF CEMENTED BIPOLAR HEMIARTHROPLASTY IN ELDERLY POPULATIONS SUFFERING FROM UNSTABLE INTER-TROCHANTERIC HIP FRACTURES
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Keywords
Unstable Intertrochanteric fractures, Hemiarthroplasty, Greater Trochanter, Lesser Trochanter
Abstract
Objective: This study aims to evaluate the surgical outcomes of Cemented Bipolar Hemiarthroplasty in elderly patients diagnosed with unstable intertrochanteric hip fractures.
Methodology: A prospective study was conducted at Liaquat National Hospital and Medical College Karachi, Pakistan, from September 2023 to September 2024. Fractures were classified according to the AO/OTA classification system, with a specific focus on Evan's classification to narrow the study parameters. Inclusion criteria encompassed patients with AO/OTA types 31-A2.2 and 31-A2.3, as well as Evan's fracture types 3 and 4. A posterolateral approach was employed for the primary cemented bipolar Hemiarthroplasty, performed with the patient in a lateral position. A T-shaped capsulotomy incision facilitated access to the joint capsule for fracture pattern analysis. The femoral head was excised at the sub-capital region by transecting it at the neck. Temporary fixation of the greater and lesser trochanters was performed based on the degree of fracture comminution and displacement.
Results: Among the 21 patients recruited for the study, 14 (66.6%) were male and 7 (33.3%) were female, with a mean age of 70 years. The age range of the participants was from 61 to 91 years. Patients were admitted for surgical intervention between 1 and 13 days post-injury, with an average presentation time of 4.33 days following the injury. The mean duration of surgery was recorded at 89.76 minutes, with an observed intraoperative blood loss averaging 426.19 ml.
Conclusion: We concluded that bipolar Hemiarthroplasty is best alternative method to manage unstable Intertrochanteric fractures in patients with severe osteoporosis.
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Mohammed Asif Peracha
Consultant Orthopaedic Surgeon Orthopaedics, Liaquat National Hospital and Medical College Karachi, Pakistan
Mushtaque Ahmed Shaikh
Professor of Orthopaedic Surgery, SMBBMU @ Chandka Medical College Larkana Pakistan
Sajjad Hussain Bhatti
Assistant Professor Orthopaedics, Pir Abdul Qadir Shah Jillani Institute of Medical Sciences (GIMS) Gambat, Khairpur Mir’s, Pakistan
Niaz Hussain Keerio
Assistant Professor Orthopaedics, Muhammad Medical College / Ibn-E-Sina University Mirpurkhas Pakistan
Muhammad Hamayun Hameed
Assistant Professor Orthopaedics, Bolan Medical Complex Hospital, Quetta Pakistan
Muhammad Faraz Jokhio
Assistant Professor Orthopaedics, Liaquat University of Medical and Health Sciences Jamshoro Pakistan