Background: Intertrochanteric femur fractures are commonly seen in elderly individuals. Treatment options for these fractures include dynamic hip screws, proximal femoral nails (PFNs), angled blade plates, and both unipolar and bipolar hemiarthroplasty. Unstable intertrochanteric fractures, classified according to the modified Evan and Jensen groups (types 2, 3, and 4), are more frequently observed in elderly patients with osteoporosis. Fractures with subtrochanteric extension, comminution of the posteromedial cortex, or reverse obliquity are considered unstable. Aims and Objective: This study aims to assess the functional outcomes of treating unstable intertrochanteric femur fractures using bipolar cemented hemiarthroplasty as the primary surgical approach. The functional assessment was conducted using the Harris Hip Score (HHS) from February 2023 to March 2025. Materials and Methods: A total of 40 patients with unstable intertrochanteric femur fractures were treated with cemented bipolar hemiarthroplasty. The study included individuals aged 65 years and older who had osteoporosis or unstable fractures. Functional outcomes were evaluated using the HHS at follow-ups conducted at 1 month, 6 months, and 1 year postsurgery. Results: The average age of participants was 70.35 years, with females accounting for 52.5% (21 patients). The mean surgical duration was 108.1 min, with an average blood loss of 296.125 mL. Postoperatively, patients had an average hospital stay of 5.325 days, and mobilization typically began within 4 days. HHSs indicated steady improvement over time: 1 month postoperatively: 68.05 (standard deviation SD = 8.42), 6 months postoperatively: 77.83 (SD = 7.68), 1 year postoperatively: 86.4 (SD = 7.31). At the 6-month follow-up, six patients showed excellent recovery, 18 had good outcomes, and 10 had fair results according to the HHS. Conclusions: Bipolar cemented hemiarthroplasty is an effective treatment for unstable intertrochanteric femur fractures in elderly patients. This approach facilitates early full weight-bearing mobilization, reducing the risk of complications associated with prolonged immobility. It can be considered a safe and reliable option for managing these fractures.
Nagar et al. (2025) studied this question.