~ 94 ~
International Journal of Orthopaedics Sciences 2023; 9(1): 94-98
E-ISSN: 2395-1958
P-ISSN: 2706-6630
IJOS 2023; 9(1): 94-98
© 2023 IJOS
https://www.orthopaper.com
Received: 01-11-2022
Accepted: 05-12-2022
Dr. Shri Vishnu M
M.S (Ortho), Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Dr. Nissanth C
MS (Ortho), Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Dr. Gadhamsetty Sai Ganesh
M.S (Ortho), Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Dr. Harish Babu J
M.S (Ortho), Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Dr. Yeshwanth Subash
DNB (Ortho), MNAMS
Professor, Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Corresponding Author:
Dr. Yeshwanth Subash
DNB (Ortho), MNAMS
Professor, Department of
Orthopaedics, Saveetha Medical
College and Hospital,
Thandalam, Chennai, Tamil
Nadu, India
Comparative study on functional outcome of unstable
intertrochanteric fractures treated with bipolar
hemiarthroplasty and dynamic hip screw fixation in
elderly population
Dr. Shri Vishnu M, Dr. Nissanth C, Dr. Gadhamsetty Sai Ganesh, Dr.
Harish Babu J and Dr. Yeshwanth Subash
DOI: https://doi.org/10.22271/ortho.2023.v9.i1b.3281
Abstract
Introduction: The surgical stabilisation of elderly proximal femur fractures has improved thanks to
recent developments. In many circumstances, the internal fixation fails. Inadequate fixing of the fracture,
fracture pattern, and poor quality of the bone are all contributing causes of internal fixation failures.
Elderly patients who have Bipolar Hemiarthroplasty (BHA) for unstable inter trochanteric fractures are
compared to those who undergo Dynamic Hip Screw (DHS) fixation.
Methods: Department of Orthopaedics conducted a study on this topic. 30 Patients with Unstable
Intertrochanteric Fractures were divided into two groups for a 12-month period of time: group A (Bipolar
Prosthesis) in 16 cases, while group B (DHS) in 14 cases.
Results: “Evaluation of the patients was done using the Harris hip score during their follow up period. In
group A, the Harris hip score at three, six, twelve months were 81.9, 76.7, 83.4 respectively. Similarly, in
group B, the Harris hip score at three, six, twelve months were 72.80, 67.03, 73.71 respectively.
Conclusions: Bipolar Hemiarthroplasty may be an effective treatment option for older patients with
osteoporotic Unstable Intertrochanteric fractures. Early mobilisation reduces the risk of problems such as
pressure sores and pulmonary issues that can arise from prolonged immobilisation, and this also leads to
better functional outcomes in Group A (BHA) than in Group B (DHS).
Keywords: Unstable intertrochanteric fractures, bipolar hemiarthroplasty, dynamic hip screw, harris hip
score
Introduction
One of the most common fractures in the senior population is the proximal femur fracture,
which has a significant impact on the health care system. Mostly occurs after a slip and fall
and is a low velocity injury. It is a life-changing occurrence in the older population, bringing
them severe pain and impairment at a vulnerable stage in their lives. After a year, patients with
proximal femur fractures only regain 30-50 percent of their pre-fracture mobility and function.
The most common cause of proximal femur fractures is a low-energy fall, which occurs more
frequently in the elderly. During a fall, the femoral neck's superolateral cortex is subjected to a
significant amount of compressive stress. Osteoporosis is a crucial factor in the ageing process.
The femoral neck's thin cortex and greater diameter all contribute to the bone's higher fracture
risk. A fall can cause a significant quantity of energy to be absorbed by a person's skin,
muscles surrounding the hip, and fat
[1]
. Because muscle mass surrounding the hip decreases
and osteoporosis worsens with age, hip fractures are becoming increasingly common among
the aged population as a whole. Internal fixation has improved the outcomes of elderly patients
with trochanteric hip fractures
[2]
. Internal fixation has a significant failure rate. Initial fracture
pattern, communication, inadequate fracture fixation, and low bone quality
[3]
were all factors
in the procedure's failure after internal fixation. Some of the early failures of internal fixation
include a loss of fixation, varus collapse, and lag screw cut off
[4]
. One group of patients is
treated with bipolar hemiarthroplasty, while the other receives Dynamic hip screw fixation.