Hip Pelvis.  2014 Jun;26(2):99-106. 10.5371/hp.2014.26.2.99.

The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures

• Kim YS
• Hur JS
• Hwang KT
• Choi IY
• Kim YH

• KMID: 2054171
• DOI: http://doi.org/10.5371/hp.2014.26.2.99

Abstract

PURPOSE
The purpose of this study was to compare the outcomes of osteosynthesis using compression hip screw fixation versus bipolar hemiarthroplasty in AO type A2 intertrochanteric fractures.
MATERIALS AND METHODS
From March 2003 to December 2009, 89 patients were included in this study. They were treated using compression hip screws (43 cases) or bipolar hemiarthroplasty (46 cases). The mean age of patients was 77.7 years (65-94 years) and the mean follow-up period was 5.9 years (1-8.3 years). For comparison of the outcomes in the two groups, statistical analyses were performed with parameters including anesthesia time, operation time, amount of transfusion, hospital stay, general complications, clinical outcome, time of partial weight-bearing using a walker, and radiological failure rate.
RESULTS
Differences in the amount of transfusion, general complications, and clinical outcome (Merle d'Aubigne and Postel score) were not statistically significant between the two groups. The bipolar hemiarthroplasty group showed better results than the compression hip screw group for anesthesia time and the time of partial weight-bearing using a walker. Radiological failures were observed in hips in one case (2.2%) of bipolar hemiarthroplasty, and in four cases (9.3%) of compression hip screw fixation.
CONCLUSION
Among elderly individuals with AO type A2 intertrochanteric fractures, patients treated with bipolar hemiarthroplasty were able to perform early ambulation. However, no significant difference in operation time, amount of postoperative transfusion, clinical results, hospital stay, and radiological failure rate was observed between the bipolar hemiarthroplasty and compression hip screw fixation groups.

Keyword

Femur; Intertrochanteric fracture; Compression hip screw; Bipolar hemiarthroplasty

MeSH Terms

Aged
Anesthesia
Early Ambulation
Femur
Follow-Up Studies
Hemiarthroplasty*
Hip Fractures*
Hip*
Humans
Length of Stay
Walkers
Weight-Bearing

Figure

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  Fig. 1 (A) A 85 years old woman patient had AO type A2 intertrochanteric fracture. (B) The postoperative radiograph shows appropriate reduction and fixation with compression hip screw. (C) The radiograph at 16 months after fixation shows complete healing of fracture.

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  Fig. 2 (A) A 77 years old woman patient had A2 type intertrochanteric fracture. (B) The immediate postoperative radiograph shows bipolar arthroplasty state. (C) The radiograph at 5 years after surgery shows stable fixation without complication.

• 

  Fig. 3 (A) A 68 years old woman patient had A2 type intertrochanteric fracture. (B) The postoperative radiograph shows stable fixation with compression hip screw. (C) At 1.5 years after surgery, radiograph shows femoral head perforation and excessive sliding.

• 

  Fig. 4 (A) A 71 years old woman patient had A2 type intertrochanteric fracture. (B) The postoperative radiograph shows bipolar arthoplasty and wiring. (C) The radiograph at 2 years after surgery shows excessive subsidence of femoral stem.

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