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General Orthopaedics

TREATMENT OF PANTROCHANTERIC HIP FRACTURES IN ELDERLY PATIENTS: INTERNAL FIXATION USING PROXIMAL FEMORAL NAIL OR BIPOLAR HEMIARTHROPLASTY

The International Society for Technology in Arthroplasty (ISTA), 28th Annual Congress. PART 1.



Abstract

Purpose

To perform comparative analysis between the results of internal fixation using proximal femoral nail system and bipolar hemiarthroplasty in pantrochanteric hip fracture in elderly patients.

Materials and Methods

From January 2006 to February 2012, we reviewed 43 patients, who were treated surgically for pantrochanterichip fractures, with a minimum of 2 years follow up. The patient's age was older than 70 year old. The patients were divided into three groups and evaluated, retrospectively. The fracture reduction were regarded as satisfactory in S-OR-IF group(17 cases) and unsatisfactory in US-OR-IF group(9 cases) and the other group was treated with bipolar hemiarthroplasty (BHA group, 17 cases.)

Results

At 24 months post-operation, S-OR-IF group had higher Harris scores, less pain, and better walking ability than S-OR-IF and BHA group. Six patients in the internal fixation group (one with S-OR-IF and five with US-OR-IF) had got reoperation.

Conclusion

For pantrochanteric fractures of old-aged patient over 70 years old, bipolar hemiarthroplasty has few of severe complications which needs reoperation, and has good results of early ambulation. However, satisfactory reduction and internal fixation makes better clinical results in long term follow-up.


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