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Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians

Title
Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians
Author
김영호
Keywords
Hemiarthroplasty; intertrochanteric fracture; octogenarians; osteoporosis
Issue Date
2014-08
Publisher
TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, TIP FAKULTESI ORTOPEDI VE TRAVMATOLOJI KLINIGI, ISTANBUL, TOPKAPI 34390, TURKEY
Citation
ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA, 2014, 48(4), p424-430
Abstract
Objective: The aim of this study was to evaluate the clinical and radiographic outcomes of bipolar hemiarthroplasty with cementless stem for the unstable intertrochanteric fracture in octogenarians and to determine the influencing factors associated with subsidence of the stem.Methods: The study included the 143 hips of 139 patients (119 females, 20 males). Mean follow-up period was 3.8 (range: 2.2 to 9.0) years. The displaced lesser trochanteric fragment was reduced anatomically and fixed with 16-gauge stainless steel cerclage wire. Clinical outcomes included Harris Hip Score (HHS), thigh pain, groin pain and walking ability. Radiographic outcomes included stem fixation and stability, osteolysis, heterotopic ossification and subsidence. The stable reduction group was determined when anatomic reduction of posteromedial fragments was achieved with <= 1 mm gap of fragment.Results: Mean HHS was 82 (range: 78 to 99) at the final follow-up. Thirty-one hips (21.7%) experienced thigh pain and 19 (13.3%) groin pain. One hundred and twelve patients (80.6%) regained their pre-injury level of ambulation. All femoral stems showed osseointegration without aseptic loosening and osteolysis. The mean stem subsidence was 3.1 +/- 2.4 (range: 0 to 18) mm. The extent of subsidence was significantly higher in patients with unstable reduction. The survival rate was 94.2%.Conclusion: Cementless bipolar hemiarthroplasty appears to be a suitable method for the treatment of intertrochanteric fracture in octogenarians. However, stable fixation of the posteromedial fragment is necessary to avoid stem subsidence.
URI
http://www.aott.org.tr/article/view/2857/3640http://hdl.handle.net/20.500.11754/47025
ISSN
1017-995X
DOI
10.3944/AOTT.2014.13.0119
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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