Peddamadyam Shravan, Arvind Kumar Bodla, Arcot Reddy Vamsi Krishna
Department of Orthopaedics, Nizam's Institute of Medical Sciences, Hyderabad, IND.
Department of Orthopaedics, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, IND.
Cureus. 2024 Feb 25;16(2):e54892. doi: 10.7759/cureus.54892. eCollection 2024 Feb.
Background and objective Intertrochanteric fractures pose a growing healthcare challenge among the elderly, demanding effective management strategies. This study addressed the rising incidence of hip fractures, emphasizing the complications associated with traditional nonsurgical approaches. It aimed to explore postoperative functional outcomes and complications associated with primary hemiarthroplasty as an alternative to internal fixation for unstable intertrochanteric fractures in the elderly. Materials and methods This study included 20 elderly patients undergoing hemiarthroplasty for unstable intertrochanteric fractures. It evaluated key variables such as patient demographics, comorbidities, fracture characteristics, surgical approach, and postoperative metrics. To perform hemiarthroplasty, we utilized a nonmodular bipolar prosthesis with cement. Postoperative follow-up included an assessment of clinical and radiological parameters, focusing on outcomes and complications. Results The mean age of the participants was 71.65 years; it was found that a significant segment of the participants (n=9, 45%) did not have any comorbidities. The surgical outcomes were characterized by minimal blood loss (275 ± 57.35 ml), short hospital stays (6.55± 1.95 days), and satisfactory operative durations (80.25 ± 10.19 minutes). Additionally, 14 (70%) patients did not require blood transfusions. After the surgery, complications were minimal, and there were no cases of deep wound complications, prosthesis dislocations, or deep vein thrombosis. The Harris Hip Scores reflected favorable outcomes in 14 cases (72.7%), with good or excellent hip scores. Conclusions Our findings revealed that primary hemiarthroplasty is a reliable and effective strategy for managing unstable intertrochanteric fractures in the elderly, providing stable joints and acceptable complication rates. Early mobilization, facilitated by hemiarthroplasty, mitigates postoperative complications, making it a viable alternative for elderly patients.
背景与目的 粗隆间骨折给老年人的医疗保健带来了日益严峻的挑战，需要有效的管理策略。本研究关注髋部骨折发病率的上升，强调传统非手术方法相关的并发症。其目的是探讨一期半髋关节置换术作为老年不稳定粗隆间骨折内固定替代方法的术后功能结果及并发症。材料与方法 本研究纳入了20例接受半髋关节置换术治疗不稳定粗隆间骨折的老年患者。评估了关键变量，如患者人口统计学特征、合并症、骨折特征、手术方式及术后指标。为进行半髋关节置换术，我们使用了带骨水泥的非模块化双极假体。术后随访包括临床和影像学参数评估，重点关注结果和并发症。结果 参与者的平均年龄为71.65岁；发现相当一部分参与者（n = 9，45%）没有任何合并症。手术结果的特点是出血量少（275±57.35 ml）、住院时间短（6.55±1.95天）和手术时间令人满意（80.25±10.19分钟）。此外，14例（70%）患者不需要输血。术后并发症极少，没有深部伤口并发症、假体脱位或深静脉血栓形成的病例。Harris髋关节评分显示14例（72.7%）结果良好，髋关节评分优良。结论 我们的研究结果表明，一期半髋关节置换术是治疗老年不稳定粗隆间骨折的可靠且有效的策略，能提供稳定的关节且并发症发生率可接受。半髋关节置换术促进的早期活动可减轻术后并发症，使其成为老年患者的可行替代方案。
