Singh Jasveer, Kumar Dinesh, Kumar Sunil, Mittal Ankit, Gupta Pradeep Kumar, Rajput Ajay Kumar, Kant Ravi, Singh Santosh Kumar
Department of Orthopaedics, Uttar Pradesh University of Medical Sciences, Etawah, IND.
Department of Orthopaedics and Traumatology, Employee's State Insurance Corporation Hospital, Jajmau, Kanpur, IND.
Cureus. 2022 Dec 14;14(12):e32526. doi: 10.7759/cureus.32526. eCollection 2022 Dec.
Introduction It is frequently challenging to treat an unstable intertrochanteric fracture in elderly people by internal fixation because of difficult anatomical reduction, poor bone quality, the need for prolonged bed rest and restricted ambulation. As an alternative to internal fixation, cemented bipolar hemiarthroplasty has been used as a treatment for unstable intertrochanteric fractures to avoid the postoperative immobilization-related complications. The aim of this study was to evaluate the functional and clinical outcomes of primary cemented bipolar hemiarthroplasty for elderly patients with unstable intertrochanteric fractures. Methodology A prospective study was conducted that included 30 patients who were admitted to the apex trauma center at a tertiary care center from January 2019 to August 2020 with unstable intertrochanteric fractures (Association for Osteosynthesis/Orthopaedic Trauma Association, or AO/OTA, types 31-A2.2 and 31-A2.3); patients treated with cemented bipolar hemiarthroplasty, with at least one year of follow-up were included in the study. Basic descriptive statistics were used and the results were presented in frequencies, percentages for categorical variables and means and standard deviations for continuous variables. Results According to the Harris Hip Score, at the end of 12 months, 9 patients (30%) had excellent results, 14 patients (46.67%) had good results, 5 patients (16.67) had fair results, and 2 cases (6.67) had poor results. With cemented hemiarthroplasty, 87.7% of older patients with unstable intertrochanteric fractures were able to walk sooner, and the results were good. Conclusion Hemiarthroplasty of the hip with a cemented bipolar prosthesis appears to be a reliable treatment method for the management of unstable intertrochanteric fractures in elderly patients with osteoporosis; it allows for early ambulation and leads to a favorable functional outcome in most patients following surgery.
引言
由于解剖复位困难、骨质质量差、需要长时间卧床休息以及活动受限，通过内固定治疗老年人不稳定型转子间骨折常常具有挑战性。作为内固定的替代方法，骨水泥型双极半髋关节置换术已被用于治疗不稳定型转子间骨折，以避免术后与固定相关的并发症。本研究的目的是评估骨水泥型双极半髋关节置换术治疗老年不稳定型转子间骨折的功能和临床结果。
方法
进行了一项前瞻性研究，纳入了2019年1月至2020年8月在一家三级护理中心的创伤中心因不稳定型转子间骨折（骨科学会/矫形创伤协会，即AO/OTA，31 - A2.2型和31 - A2.3型）入院的30例患者；接受骨水泥型双极半髋关节置换术且随访至少一年的患者被纳入研究。使用基本描述性统计方法，结果以频率、分类变量的百分比以及连续变量的均值和标准差表示。
结果
根据Harris髋关节评分，在12个月末，9例患者（30%）结果为优，14例患者（46.67%）结果为良，5例患者（16.67%）结果为中，2例患者（6.67%）结果为差。采用骨水泥型半髋关节置换术，87.7%的老年不稳定型转子间骨折患者能够更早行走，且结果良好。
结论
骨水泥型双极假体半髋关节置换术似乎是治疗老年骨质疏松性不稳定型转子间骨折的可靠方法；它允许早期活动，并在大多数患者术后带来良好的功能结果。
