Volume : 3, Issue : 11, November - 2014

A Study on Internal Fixation Versus Primary Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly Patients.

Dr. Kevin Rajesh Choksey, Dr. H. P. Bhalodiya, Dr. Z. M. Patel, Dr. Kalpesh Mehta, Dr. Yusuf A Harmal, Dr. Rahul R. Parmar

Abstract :

DHS may result in cut-out,instability, & delayed weight bearing. For unstable osteoporotic trochanteric fractures, hemiarthroplasty can transfer axial load from hip to middle femur. Between 2012 & 2013, 20 patients underwent hemiarthroplasty using a cemented bipolar prosthesis. 30 patients underwent internal fixation using a DHS. There were no significant differences between 2 groups in terms of sex, age, fracture type, Singh index, follow-up period,rate of complications and functional evaluation after 6 months. Hemiarthroplasty patients were allowed full weight bearing significantly earlier. Among hemiarthroplasty, 2 infections, 1 foot drop, 1 dislocation and among internal fixation group, complications were 2 lag screw cut outs, 2 nonunions, 1 avascular necrosis, 2 deep seated infections. Harris hip score in hemireplacement was 83% and 71% in fixation.To allow earlier postoperative weight- bearing & to avoid excessive collapse at the fracture site, prosthesis is a good option. In unstable IT fractures, early complications are less with hemiarthroplasty.