Treatment of unstable intertrochanteric fractures with cemented bipolar prosthesis- A prospective study

Introduction: Peritrochanteric fractures comprise of fractures of trochanter, subtrochanteric region and basi-cervical fractures and are the commonest fractures encountered. Patients with unstable intertrochanteric fractures need immediate mobilization to avoid serious complications. Material and Methods: 43 patients with unstable intertrochanteric fractures were randomized and operated using the cemented bipolar prosthesis between September 2011 and August 2013. The inclusion criteria were patients more than 65 years of age, unstable intertrochanteric fracture (Type III and type IV as per Evans classification). Patients with polytrauma and medically unfit patients were excluded from the study. Results: Mean age was 76.65± 5.48 years. The most common mechanism of injury was domestic fall comprising of 87%. The average duration of surgery from the time of injury was 3.5±1.3 days. The average surgical duration was 03.5 mins. The average duration of stay in hospital was 8.4±1.68 days. Final results were calculated using the Harris Hip score with 97% cases as excellent and good while 3% had fair results respectively. Follow-up was done at 1, 3, 6, 12 and 24 months. Conclusion: Cemented bipolar hemiarthroplasty in unstable intertrochanteric fractures has an advantage of stable adequate fixation with early return to activities of daily living, thus preventing serious life threatening complications.