J Korean Hip Soc.  2010 Jun;22(2):159-165. 10.5371/jkhs.2010.22.2.159.

Standard Type Cemented Hemiarthroplasty with Double Loop and Tension Band Wiring for Unstable Intertrochanteric Fractures in the Elderly

• Cho HM
• Lee SR
• Park MS
• Chung WC

• KMID: 1461138
• DOI: http://doi.org/10.5371/jkhs.2010.22.2.159

Abstract

PURPOSE
To determine follow-up results for elderly patients with osteoporosis that received standard cemented bipolar hemiarthroplasty with double loop and tension band wiring for treatment of unstable intertrochanteric hip fractures.
MATERIALS AND METHODS
Between May 2000 and May 2006, 86 cemented bipolar hemiarthroplasties were done in elderly patients who had unstable intertrochanteric fractures. The mean age at the time of surgery was 82 years. The average follow-up period was 5.3 years. We evaluated post-operative results by clinical and radiographic methods.
RESULTS
At the final follow-up, the mean Harris hip score was 79.2. The mean time needed for full weight bearing following surgery was 4.2 weeks and 82.5 % of patients regained their preoperative level of ambulation. All patients achieved union in the lesser trochanter fracture, but substantial trochanter displacement was observed in 4 cases. There was one case of acetabular erosion. Superficial infections were found Post-operatively in 2 cases. One case with stem subsidence (<5 mm) showed satisfactory results without subsidence in further follow-ups.
CONCLUSION
If cemented bipolar hemiarthroplasty is properly applied in the treatment of unstable intertrochanteric hip fractures in the elderly, systematic postoperative rehabilitation, and pain control can be achieved.

Keyword

Hip; Intertrochanteric fracture; Bipolar hemiarthroplasty

MeSH Terms

Aged
Displacement (Psychology)
Femur
Follow-Up Studies
Hemiarthroplasty
Hip
Hip Fractures
Humans
Osteoporosis
Walking
Weight-Bearing

Figure

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  Fig. 1 (A) The lesser trochanter is reattached with a double loop wiring. (B) A autograft is cut from the head/neck fragment to fit on posteromedial aspect and greater trochanter.

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  Fig. 2 (A) Preoperative radiograph of a 84 year-old woman shows comminuted unstable femoral intertrochanteric fracture. (B) Immediate postoperative radiograph shows stable stem insertion state using cement and well reduced fracture fragment with double loop wiring, figure of 8 wiring. (C) Last follow up (4 years after operation) radiograph shows stable stem and well union of trochanter.

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