Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures.

The results of 55 consecutive hemiarthroplasties in 54 elderly patients with intertrochanteric fractures were reviewed. The mean age of the patients was 84.2 years (range, 73-99 years). Standard cemented hemiarthroplasty was used and the fractured posteromedial fragment was retained. Two patients were lost to followup and 12 patients died within 6 months of their fractures. The mean length of followup was 13.6 months (range, 6-24.6 months) for the remaining 40 patients (41 hips). Nineteen patients maintained the same walking category as before fracture and eight of these patients had no increase in the dependency on walking aids. The greatest deterioration of walking function occurred in the subgroup of six patients who had a history of confusion and frequent falls. The medical complications are comparable with those described in other series. There were few surgical complications. The authors of this study think that the use of standard cemented hemiarthroplasty is a reasonable alternative to a sliding screw device for the treatment of intertrochanteric fractures. Longer-term studies with larger numbers of patients are required to address the issues of late complications and whether the reconstructions are durable enough for the long-surviving patients.