J Korean Fract Soc.  2009 Oct;22(4):239-245. 10.12671/jkfs.2009.22.4.239.

Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly

• Kho DH
• Kim KH
• Kim HJ
• Kim DH

• KMID: 1469989
• DOI: http://doi.org/10.12671/jkfs.2009.22.4.239

Abstract

PURPOSE
To evaluate the results of the treatment of femoral basicervical fractures aged 75 years or older. MATERIALS AND METHODS: We reviewed the clinical records of 60 patients who were older than 75 years and who underwent bipolar hemiarthroplasty for femoral basicervical fractures using calcar replacement stem between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability and modified Harris hip score, the activities of daily living, the associated medical conditions and arthritis, and postoperative disgnosis. RESULTS: The mean Harris hip score were 87.2 (74~92). Walking ability was recovered in 91% (55 cases) and activity of daily living was achived in 91% (55 cases). Press-fit fixations were 56 cases and bony ingrowth fixations were 57 cases. Stress shields were 28% (17 cases). Thigh pains were 5% (3 cases) and revision rate was 3% (2/60 cases). CONCLUSION: We consider bipolar hemiarthroplasty using calcar replacement stem in femoral basicervical fractures in the Elderly with severe osteoporosis is the useful treatment in view of the stable and rigid fixation of femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.

Keyword

Elderly; Basiccervical fractures; Calcar replacement stem; Bipolar hemiarthroplasty

MeSH Terms

Activities of Daily Living
Aged
Arthritis
Early Ambulation
Follow-Up Studies
Hemiarthroplasty
Hip
Humans
Osteoporosis
Thigh
Walking

Figure

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  Fig. 1 Recovery of activity of daily life by Koval and Zukerman.

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  Fig. 2 A 80-year-old female with right hip pain. (A) Preoperative radiograph showing a Garden stage IV basicervical femoral neck fracture. (B) Postoperative radiograph after bipolar hemiarthroplasty using calcar replacement stem. (C) Postoperative 36 month follow-up radiograph showing no position change or subsidence of the stem.

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