J Korean Hip Soc.  2008 Dec;20(4):273-277. 10.5371/jkhs.2008.20.4.273.

Comparison of the Clinical Outcomes between Internal Fixation and Primary Hemiarthroplasty for Treating Unstable Intertrochanteric Fracture in the Elderly

• Moon CY
• Ji JH
• Park SE
• Kim YY
• Lee SW
• Kim WY

• KMID: 2162610
• DOI: http://doi.org/10.5371/jkhs.2008.20.4.273

Abstract

PURPOSE
We wanted to analyze the clinical outcomes of prospectively randomized surgeries between internal fixation and hemiarthroplasty for treating unstable intertrochanteric hip fracture in elderly patients.
MATERIALS AND METHODS
From January, 2004 to December, 2007, 62 cases of unstable intertrochanteric fracture that underwent internal fixation or hemiarthroplasty were analyzed retrospectively for the clinical outcomes with using the SF-36. Thirty cases were treated with internal fixation and 32 cases were treated with hemiarthroplasty. The clinical outcomes, as assessed by using the SF-36, were statistically analyzed with using SPSS for Windows.
RESULTS
Hemiarthroplasty show a better result than internal fixation for pain, limping and the support scales in the 70~79 years old group, and the limping scale was also better in the over 80 years old group (P<0.05). There were no differences between the two groups according to age. Four cases of internal fixation failed due to loss of fixation (3)and nonunion (1), and 4 cases of hemiarthroplasty failed due to infection (2) and revision for dislocation (2).
CONCLUSION
Primary hemiarthroplasty should be more beneficial than osteosynthesis, such as performing internal fixation, for treating unstable intertrochanteric fracture in elderly patients because of the reduced pain and early ambulation that are due to the early stabilization.

Keyword

Unstable intertrochanteric fracture; Internal fixation; Hemiarthroplasty

MeSH Terms

Aged
Dislocations
Early Ambulation
Hemiarthroplasty
Hip
Humans
Retrospective Studies
Weights and Measures