Short Term Analysis of Primary Cemented Hemiarthroplasty for Unstable Trochanteric Fractures in Elderly Patients

Karthik, K (2007) Short Term Analysis of Primary Cemented Hemiarthroplasty for Unstable Trochanteric Fractures in Elderly Patients. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Hip fractures most often affect the elderly and have a tremendous impact on both the health care system and society in general. In human beings any affection of the hips is of much concern since it offers locomotion. From the very beginning most of the proximal femur fractures in the elderly were associated with considerable co morbidity. The intertrochanteric fractures occur in the more elderly age group than femoral neck fractures. Most inter trochanteric hip fractures can be treated successfully with internal fixation. Failure rates as high as 56% have been noted in certain problematic fracture patterns - Haidukewych et al. The failure after internal fixation had been due to initial fracture pattern, communition, sub optimal fracture fixation and poor bone quality. The failed treatment of hip fractures typically leads to profound functional disability and pain. AIM: The aim of this prospective study is to analyse the short term follow up results of primary cemented hemi arthroplasty in unstable trochanteric fractures of the elderly done in our institution from May 2003 to April 2006. MATERIALS AND METHODS: This study was conducted at Madras Medical College and Government General Hospital on 20 elderly osteoporotic patients with unstable inter trochanteric fractures from January 2004 to April 2006. All the patients were treated with cemented Thompson or Bipolar prosthesis. Preoperatively for the entire patients X ray pelvis with both hips AP and X ray of the involved hip AP view were taken. The grade of Osteoporosis was evaluated by Singh’s index over the normal side. RESULTS: In our study all the patients were evaluated clinically using Harris Hip Score at various follow up period. Based on the Harris Hip Score (HHS), the results were graded as excellent, good, fair and poor as follows: Excellent : > 90 points, Good : 80-89 points, Fair : 70-79 points, Poor : <70 points. CONCLUSION: In unstable intertrochanteric fractures of the elderly patient with osteoporosis, cemented hemiarthroplasty is one of the best choice. This study as is shown in other similar studies stresses that cemented hemiarthroplasty for unstable intertrochanteric fractures was better than those treated with other modalities like conservative, Jewett nail plate, Enders nail, Harris condylo cephalic nail, Gamma nail and DHS. The major advantage is early full weight bearing and rapid rehabilitation. It markedly reduces the problems associated with long periods of inactivity such as pneumonia, venous thrombosis, pulmonary embolism and decubiti ulcers. It also obviates the possibilities of nonunion, delayed union, mal union, nai (or) screw cut hrough, varus collapse etc. It is also cost effective since it has fewer reoperations, decreased hospitalization, improved nursing care and improved function. Though the experience was short the results are encouraging.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Short Term Analysis ; Primary Cemented Hemiarthroplasty ; Unstable Trochanteric Fractures ; Elderly Patients.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 02:07
Last Modified: 14 Sep 2017 02:10

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