International Journal of Research in Orthopaedics | March-April 2019 | Vol 5 | Issue 2 Page 1 International Journal of Research in Orthopaedics Kanchan S et al. Int J Res Orthop. 2019 Mar;5(2):xxx-xxx http://www.ijoro.org Original Research Article Primary arthroplasty as an option for surgical treatment of unstable intertrochanteric fracture femur in elderly patients: a retrospective study Shashank Kanchan 1 , Vikash Raj 1 *, Dinesh Agarwal 1 , Richa 2 INTRODUCTION Fracture of intertrochanteric region is a common occurrence in elderly age group. It accounts for about 20% of all the fractures in patients 50 years and older age. 1 The global burden of the disease was estimated to be about 1.6 million in the year 1990 and it is expected to increase up to 6.26 million by the year 2050. 2,3 The trend of increase in incidence of intertrochanteric fractures can be explained by the fact that the average life expectancy has increased and so has the problems due to osteoporosis and other co morbid conditions. 4 Most of these fractures occur due to low energy trauma or even a trivial fall. It was shown in the study by Bergstterom et al that trivial fall i.e. fall from <1 m accounts for about 53% of all the fractures in patients above 50 years of age and the percentage is about 80% for person more than 75 years of age. 5 The management of these fractures in elderly patients should be definitive and allow early weight bearing in the postoperative period to give them the best ABSTRACT Background: An unstable intertrochanteric fracture in osteoporotic elderly patients presents a very challenging problem to the surgeons. This category of patients if kept in bed for long tends to have many complications like deep vein thrombosis, pneumonia, bed sores, etc. Surgeon’s worldwide face difficulty in getting a good anatomical reduction and do not allow early mobility to these patients because of risk of loss of reduction and implant cut out. The purpose of our study is to study the usefulness of arthroplasty in these patients in terms of better functional outcomes and no increase in complication rates. Methods: It was a retrospective study involving 25 patients (17 females, 8 males) with mean age of 76±2.3 years having intertrochanteric femur fractures (AO type A 2.2 and above) with osteoporosis operated upon with bipolar hemiarthroplasty at IQ City Medical College and NM Hospital between January 2015 and January 2017. Results: All the patients were followed up for a period of 1 year. We had a mean operative time of 75 min (range 55- 125 min) with an average blood loss of 450 ml. 4 of our patients required postoperative blood transfusion. All patients walked on 2 nd postoperative day. We had a mean Harris hip score of 82 and mean VAS of 1 at the end of 1 year. Conclusions: Hemiarthroplasty done in cases of unstable intertrochanteric femur fractures in elderly patients with osteoporotic bones allows early weight bearing thus improves the final functional outcomes. Further randomized trials are required before deriving any conclusions. Keywords: Hemiarthroplasty, Unstable intertrochanteric fractures, Osteoporotic fractures 1 Department of Orthopedics, 2 Department of Community Medicine, IQ City Medical College, Durgapur, West Bengal, India Received: 22 December 2018 Revised: 18 January 2019 Accepted: 21 January 2019 *Correspondence: Dr. Vikash Raj, E-mail: drvikashraj@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20190425