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Primary hemiarthroplasty for treatment of unstable pertrochanteric femoral fractures (AO/OTA Type 31 A2.3) in elderly osteoporotic patients

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of this study was to prospectively analyze the role of primary hemiarthroplasty in unstable osteoporotic pertrochanteric fractures (AO/OTA Type 31 A2.3), with emphasis given to postoperative Functional Independent Measure (FIM) and Harris Hip Score (HHS).

Methods: Fifty-six consecutive patients (average age 78.25 ± 5.45), out of which 24 males (79.29 ± 4.99) and 32 females (77.47 ± 5.72), with unstable pertrochanteric femoral fractures, operated with primary hemiarthroplasty procedure from 2012 to 2014 were included in this prospective study with a follow-up of two years. Primary outcomes were FIM and HHS. Secondary outcomes included duration of surgery, estimated intraoperative blood loss, time to first postoperative full weight-bearing, time to walking ability with and without crutches, average hospital stay, postoperative complications, and mortality.

Results: The FIM score at 3 months was 85.9 ± 5.7. HHS at two years was excellent for 41 patients (73, 2%), good for eight (14.3%), fair for four (7.1%), and poor for three (5.4%). The mean duration of surgery was 62.6 min, estimated intraoperative blood loss 175.5 mL, time to first postoperative full weight-bearing 2.2 ± 0.4 days, ability to walk with crutches 6.3 ± 1.8 days and without crutches 44.2 ± 12.7 days, and the average hospital stay was 9.6 ± 2.7 days.

Conclusion: This study highlighted good clinical postoperative outcome scores for primary hemiarthroplasty for the treatment of unstable pertrochanteric femoral fractures in elderly osteoporotic patients. This procedure seems to be secure and effective, and offers a good quality of life in terms of FIM and HHS.

No MeSH data available.


Related in: MedlinePlus

Determination of femur length, fixation of greater trochanter by tension band wires.
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Figure 1: Determination of femur length, fixation of greater trochanter by tension band wires.

Mentions: The joint capsule was opened using a T-shaped capsulotomy and the femoral head was extracted and measured (Figure 1). The femoral neck was cut following the preoperative planning measurement. Temporary reduction and fixation of the greater and lesser trochanter were performed to determine femoral length and antetorsion. Femoral canal preparation was then undertaken, using progressive rasps to achieve a good purchase of the trial implant into the shaft. The range of motion and joint stability were checked with the trial implants in place.


Primary hemiarthroplasty for treatment of unstable pertrochanteric femoral fractures (AO/OTA Type 31 A2.3) in elderly osteoporotic patients
Determination of femur length, fixation of greater trochanter by tension band wires.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384320&req=5

Figure 1: Determination of femur length, fixation of greater trochanter by tension band wires.
Mentions: The joint capsule was opened using a T-shaped capsulotomy and the femoral head was extracted and measured (Figure 1). The femoral neck was cut following the preoperative planning measurement. Temporary reduction and fixation of the greater and lesser trochanter were performed to determine femoral length and antetorsion. Femoral canal preparation was then undertaken, using progressive rasps to achieve a good purchase of the trial implant into the shaft. The range of motion and joint stability were checked with the trial implants in place.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of this study was to prospectively analyze the role of primary hemiarthroplasty in unstable osteoporotic pertrochanteric fractures (AO/OTA Type 31 A2.3), with emphasis given to postoperative Functional Independent Measure (FIM) and Harris Hip Score (HHS).

Methods: Fifty-six consecutive patients (average age 78.25 ± 5.45), out of which 24 males (79.29 ± 4.99) and 32 females (77.47 ± 5.72), with unstable pertrochanteric femoral fractures, operated with primary hemiarthroplasty procedure from 2012 to 2014 were included in this prospective study with a follow-up of two years. Primary outcomes were FIM and HHS. Secondary outcomes included duration of surgery, estimated intraoperative blood loss, time to first postoperative full weight-bearing, time to walking ability with and without crutches, average hospital stay, postoperative complications, and mortality.

Results: The FIM score at 3 months was 85.9 ± 5.7. HHS at two years was excellent for 41 patients (73, 2%), good for eight (14.3%), fair for four (7.1%), and poor for three (5.4%). The mean duration of surgery was 62.6 min, estimated intraoperative blood loss 175.5 mL, time to first postoperative full weight-bearing 2.2 ± 0.4 days, ability to walk with crutches 6.3 ± 1.8 days and without crutches 44.2 ± 12.7 days, and the average hospital stay was 9.6 ± 2.7 days.

Conclusion: This study highlighted good clinical postoperative outcome scores for primary hemiarthroplasty for the treatment of unstable pertrochanteric femoral fractures in elderly osteoporotic patients. This procedure seems to be secure and effective, and offers a good quality of life in terms of FIM and HHS.

No MeSH data available.


Related in: MedlinePlus