Primary Cementless Hip Arthroplasty in Unstable Intertrochanteric Femur Fracture in Elderlys: Short-term Results.

PURPOSE: This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys.

MATERIALS AND METHODS: Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score. Retrospective evaluation was performed by operative time, transfusion amount, time to operation days, hospital stay and time to full weight bearing. Clinically, ambulatory ability was checked by Parker and Palmer (P&P) score and function of hip was appraised by Harris hip score (HSS). Radiologically, bone healing of fractured trochanteric fragment and presence of subsidence, stress shielding or osteolysis were checked.

RESULTS: Fracture type was 11 cases of A2.2, 18 cases of A2.3 and 6 cases of A3.3. Femoral stems used were 8 cases of rectangular tapered wedge type and 27 cases of fluted modular distal fixation type. P&P score improved from mean preinjury score of 7.1 to mean postoperative last follow-up score of 6.5. Median HHS at last follow-up was 75. Mean time to full weight bearing was 47 days (24-79 days). Postoperative complications were one case of linear periprosthetic femoral fracture and one case of postoperative dislocation.

CONCLUSION: Cementless hip replacement arthroplasty could be a good option for unstable intertrochanteric femoral fracture in elderlys.