Treatment of unstable intertrochanteric fracture in geriatric patients using primary cemented bipolar hemiarthroplasty with calcar femorale reconstruction: a prospective study

BACKGROUND: There is debate in the management of unstable intertrochanteric femur fracture in elderly population. Proximal femoral nail (PFN), dynamic hip screw (DHS), and cemented bipolar hemiarthroplasty are the most used treatment modalities. The aim of our study was to evaluate the outcome of primary cemented bipolar hemiarthroplasty with calcar reconstruction in older patients with unstable intertrochanteric femur fracture and to mobilize the patient early to prevent postoperative complications.METHODS: This is a prospective study of 20 cases of the unstable introchanteric hip fractures treated by primary cemented bipolar hemiarthroplasty with calcar reconstruction. Patients were explained about the procedures, complications, and postoperative protocols.RESULTS: A total of 20 patients met the inclusion criteria of unstable trochanteric fracture (AO/OTA type A2.1, A2.2, A2.3). All patients were operated with primary cemented bipolar hemiarthroplasty with calcar reconstruction. The functional results were graded according to Harris Hip Scoring System, where a score of more than 90 indicated excellent result, a score between 80 and 90 indicated good results, a score between 70 and 80 indicated fair results, and a score below 70 was rated as poor.CONCLUSIONS: Primary cemented bipolar hemiarthroplasty with calcar reconstruction is an excellent alternative in older patients with unstable intertrochanteric femur fracture and leads to reduce postoperative complication and early mobilization.