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August 23, 2026CureusOpen Access

Primary Cemented Bipolar Hemiarthroplasty Versus Proximal Femoral Nail Fixation for Unstable Intertrochanteric Fractures in Osteoporotic Elderly Patients: A Prospective Observational Study

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Authors

ASAnurag SharmaMMManish MehtaSSShiv Prakash Sharma

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Implication

Prospective observational study reveals earlier weight-bearing and better functional scores with hemiarthroplasty in elderly hip fracture patients, highlighting benefits for rapid recovery.

Key Points

  • To compare functional outcomes, postoperative mobilization times, and complication rates between primary cemented bipolar hemiarthroplasty (BHA) and proximal femoral nail (PFN) fixation in osteoporotic elderly patients with unstable intertrochanteric fractures.
  • Conducted a prospective observational study at a single tertiary orthopedic center (April 2022 to June 2025) including 60 patients aged 60–80 years with unstable Evans type III–IV intertrochanteric fractures.
  • Allocated patients to receive either primary cemented BHA (n=30) or PFN fixation (n=30) based on surgical team determination, with primary follow-up evaluated at one year.
  • BHA patients achieved full weight-bearing significantly earlier than PFN patients (5.87±3.97 days vs. 12.83±1.62 days; p<0.001).
  • At one-year follow-up, the BHA cohort demonstrated significantly higher Harris Hip Scores (89.44±4.69 vs. 85.79±8.26; p=0.048) and Parker-Palmer Mobility Scores (8.15±0.95 vs. 7.38±0.86; p=0.002).
  • Revision surgery occurred in 3.3% (1/30) of the BHA group versus 13.3% (4/30) of the PFN group, while limb length discrepancy >10 mm occurred in 10% (3/30) of BHA patients and 0% of PFN patients.

Cite This Study

Sharma et al. (2026) studied this question.

synapsesocial.com/papers/6a8aad857677a34114445b7bhttps://doi.org/10.7759/cureus.114899
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation.1989 · 180 citations
  2. 2Fixation of intertrochanteric fractures of the femur. A randomised prospective comparison of the gamma nail and the dynamic hip screw1991 · 546 citations
  3. 3Treatment of Intertrochanteric Fracture of the Femur Using Sliding Screw Plate Fixation1982 · 207 citations
  4. 4Cemented Hemiarthroplasties for Elderly Patients With Intertrochanteric Fractures2000 · 137 citations
  5. 5A new mobility score for predicting mortality after hip fracture1993 · 905 citations