Treatment of Intertrochanteric Fracture in Elderly Patients with Preservation of Calcar Femorale and Hemiarthroplasty

Chu, In Tak; Kim, Jung Man; Yeon, Gun; Ryu, Kwang Jae

Abstract

Seven patients with femur fractures were treated with external fixators. The average age at fracture Intertrochanteric fracture of the femur, of which reported mortality ranges from 15% to 20%, usually occurs in the elderly and is usually comminuted and unstable. Many operative techniques have been developed for early exercise and walking ambulation to reduce mortality and morbidity, but they still have disadvantages. Few papers has been reported on hemiarthroplasty for intertrochanteric fracture in elderly patient, but they did not preserve the calcar femorale which is very impartant anatomic portion for weight transmission after hemiarthroplasty Therefore, the purpose of this paper is to analyze clinical outcome of hemiarthroplasty with preseuation of calcar femorale and wiring of greater trochanter for intertro chante ric fracture. From March 1993 through March 1995. 28 elderly patients had undergone hemiarthroplasty with preservation of calcar femorale and wiring of greater trochanter for the treatment of severely comminuted and osteoporotic intertrochanteric fractures. Mean follow-up period was 17.5 months ranging from 12 months to 28 months. The results obtained were as follows : 1. The most common type by Boyd-Griffin classification was II(73%). 2. Twenty five cases(83%) had osteoporosis, which was evaluated by Singh index. 3. The average operating time was 42.8 minutes and average hospitalifation period was 20.6 days. 4. Excellent functional results according to hip rating scale of Merie DAubigne were obtained in 24 cases(80%). 5. Creater trochanter fixed with wire was united in average 4.4months postoperatively. 6. One case(3%) developed loosening of implant at postoperative 13 months.