Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hip
Abstract number: 26219
PRIMARY CEMENTED HEMIARTHROPLASTY FOR UNSTABLE
INTERTROCHANTERIC FRACTURES IN ELDERLY OSTEOPOROTIC PATIENTS
Karthik K 1 , Manju RAMAPPA 1 , Mayilvahanan NATARAJAN 2
1 James cook university hospital, Middlesbrough (UNITED KINGDOM), 2 Madras
Medical College and Government General Hospital, Chennai. (INDIA)
Unstable intertrochanteric fractures in patients with severe osteoporosis are among
the most difficult fractures to treat. Fixation failure often leads to prolonged morbidity
and poor functional outcome. Primary replacement seems a suitable option to
minimize complications in this selected group of patients. A prospective study was
conducted between Jan 2004 and April 2006 at a tertiary referral unit. Patients with
unstable intertrochanteric fractures and osteoporosis were included. Unstable
fractures were identified on radiographs by the senior author and osteoporosis
confirmed from previous bone densitometry results. Patients unable to consent were
excluded from the study. Twenty patients comprising of 11 females and 9 males
formed the study cohort. The mean age was 69 (52 95) years and the mean follow
up was 4.6 (3 6) years. One patient died on the sixth postoperative month and two
patients were lost to follow up. There were two dislocations one in the immediate
post operative period and the other one month later with greater trochanteric fracture.
One patient had periprosthetic fracture and two patients experienced leg length
discrepancy. The study showed 66% excellent and 22% good results according to
the Harris Hip Score system. Primary endoprosthetic replacement has provided
satisfactory results with good functional recovery in our experience. Due to unstable
nature of the fracture, internal fixation has a high failure rate, especially in the
presence of severe osteoporosis. Cemented hemiarthroplasty seems to be a
suitable option for patients with unstable intertrochanteric fracture and osteoporosis.
566