Volume 24, Issue 103, May - June, 2020

Early results of long stem bipolar cementless hemiarthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients

Quang-Tri Lê^1♦, Minh-Hoang Nguyen²

¹Department of Orthopedics, 7A Military Hospital, 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706 Vietnam. Email: lqtri@ntt.edu.vn
²Department of Orthopedics, 7A Military Hospital, 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706 Vietnam. Email: hoangbss@gmail.com

^♦Corresponding author
Director of 7A Military Hospital; Head of Department of Orthopedics; Head of Department of High-Tech Diagnostic; 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706, Vietnam. Email: lqtri@ntt.edu.vn / tsbstri@yahoo.com

ABSTRACT

Aims and objectives: The study aimed to evaluate the early results of long stem bipolar cementless hemiarthroplasty for the treatment of unstable intertrochanteric fractures in senor patients and functional rehabilitation after surgery. Methodology: This prospective research included 68 intertrochanteric fracture patients aged over 75 years, with type A2 and A3.3 of AO foundation classification (Arbeitsgemeinschaft für Osteosynthesefragen), treated with long stem bipolar cementless hemiarthroplasty at the 7A Military Hospital from Jan 2016 to October 2019. Studied patients were monitored and evaluated for three months after the operation. Results: The average age of the patients was 84 ± 9 years. There were 22 male and 45 female patients. Domestic accidents accounted for all cases. Two cases had surgical wound infection with retentive mucus; in one case, the femoral stem pierced the bone cortex, and two cases had ruptured fixation steel suture, one case had pierced cortical bone caused by the femoral stem. No case resulted in death within the postoperative three months. Remarkably, 56/58 cases (82.4%) had soon resume walking (postoperative day fourth – day seventh). Functional rehabilitation results (based on Modified Harris scale) were “very good” and “good” in 89.4% cases, “average” in 8.8% cases, and “poor” in 1.8% cases. Discussion: Long stem bipolar hip replacement was found to be suitable to treat intertrochanteric fractures in the elderly as it provided fast rehabilitation. Modified Handinger incision approach and various fixation techniques such as steel cord and stem installment were discussed and proved to be effective. MHHS showed advantages to be used in Vietnam conditions. Conclusion: Long stem bipolar cementless hemiarthroplasty for the treatment of unstable intertrochanteric fractures in the elderly was shown to result in good outcomes. The treatment enabled walking and muscular rehabilitation in the patients, enabled the patients to resume daily activities quickly, reduced care burden, and promoted life quality for the patients.

Keywords: Hemiarthroplasty; Intertrochanteric fractures; Rehabilitation; Elderly

Medical Science, 2020, 24(103), 981-988

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