Study of outcomes of cemented hemiarthroplasty for comminuted intertrochanteric fractures in the elderly

Aims & objectives: To assess the functional outcomes of the unstable intertrochanteric fractures in the osteoporotic individuals treated by primary cemented hemiarthroplasty by early mobilization and immediate weight-bearing, restoration of limb length, and gait Assessment. Materials and methods: It is a prospective study of 17 elderly patients with comminuted intertrochanteric fractures managed with cemented hemiarthroplasty attending to the Department of Orthopaedics, Government General Hospital, Rangaraya medical college, Kakinada. Results: 17 cases of unstable intertrochanteric fractures were treated with cemented bipolar hemiarthroplasty. The average follow-up period was 12 months. The average age was 72.75 years with a standard deviation of 5.56. Most (82.3%) of the patients presented with Boyd and Griffin type 2 fracture. The functional assessment by HHS showed good to excellent outcomes in most of the patients (64.7%). 2 patients had abductor weakness, 1 patient had superficial surgical site infection, one had hypotension, and 1 patient had bedsore. Conclusions: Primary cemented bipolar prosthetic replacement in comminuted intertrochanteric fractures in the elderly patients provide s painless, stable, and mobile hip joint so that we can institute early postoperative mobilization which can avoid the consequences of prolonged recumbency. Hemiarthroplasty also avoids a second procedure in such elderly patients with multiple comorbidities as there is a high risk of failure of internal fixation in patients with poor bone quality, subjecting them to a second surgery and anaesthesia being a risky proposition.