Vijayakumar, P (2014) Study of functional outcome of primary hemiarthroplasty in the management of comminuted intertrochanteric fractures of femur in the elderly patients. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
INTRODUCTION : Unstable osteoporotic intertrochanteric fractures are common in the elderly population. Failure rate of as high as 56% have been noted with internal fixation of unstable fractures mainly due to inadequate purchase in the osteoporotic bone and early full weight bearing. Hemiarthroplasty is a frequently employed alternative as it gives stability and allows immediate full weight bearing . This study evaluates the role of primary cemented hemiarthroplasty in the treatment of unstable trochanteric fractures in elderly and physiologically elderly patients. MATERIALS AND METHODS: 20 elderly patients who were above 60 years of age with unstable osteoporotic intertrochanteric fractures, who underwent cemented bipolar hemiarthroplasty were studied prospectively from July 2011- Decemnber 2013. Patients who were less than 60 years of age, non ambulatory before injury and patients with stable intertrochanteric fractures,pathological fractures congnitive impairment were excluded from the study. Fractures were classified based on Boyd and Griffin classification. All the patients were treated with cemented bipolar prosthesis through posterior (Moore’s) approach. Mean follow up period was 12 months. Patients were assessed using modified Harris hip score. RESULTS : In our study,mean age of the patient was 69.4 yrs,18 cases were of type 2 fractures , 2 cases were type 3 fracture.8 patients had limb shortening of less than 2 cms, whereas1patient had limb shortening of 3 cms.5 patients had abductor weakness. As assessed by modified Harris hip score, excellent to fair results were obtained at 12 months follow up in 15 cases (75 %), 2 cases (10%) had poor results. 3 patients died postoperatively due to unrelated causes. One patient had superficial infection who was treated with i.v. antibiotics. In our series we had no Complications like stem loosening, periprosthetic fractures, prosthetic dislocations. CONCLUSION: Primary cemented hemiarthroplasty for unstable osteoporotic elderly trochanteric fractures appears to be a good alternative treatment modality. Early full weight bearing and rehabilitation is a definitive advantage of this method.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Intertrochanteric fracture, primary bipolar hemiarthroplasty, elderly patients. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 18 Sep 2017 01:18 |
| Last Modified: | 18 Sep 2017 01:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3014 |
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