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Treatment of Unstable Intertrochanteric Fracture in Elderly Patients : Comparison between the Results of Internal Fixation Using Compression Hip Screw and Cemented Bipolar Hemiarthroplasty
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Myung Sik Park, Woo Chul Jung, Hyuk Park, Byung Yun Hwang, Young Jin Lim, Myung Guk Jung, Hong Man Cho
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J Korean Fract Soc 2009;22(3):138-144. Published online July 31, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.3.138
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 Abstract
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- PURPOSE
To perform comparative analysis between the results of internal fixation using compression hip screw and cemented bipolar hemiarthroplasty in unstable intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
From January 2001 to October 2006, we reviewd 73 patients, who were treated surgically for unstable intertrochanteric fractures, with a minimum of 2 years follow up. The patient's age was older than 60 year old. The patients were divided into two groups and evaluated, retrospectively. One group was treated with cemented bipolar hemiarthroplasty (Group A, 34 cases), and the other group was treated with compression hip screw (Group B, 39 cases). We evaluated the amount of intraoperative bleeding, operative time, clinical results and complications between the two groups.
RESULTS
The amount of intraoperative bleeding and operative time were no statistically significant between the two groups. Group A showed a better result than Group B for clinical outcome using Johnson Daily Activity of Life. Complications in the group A were comprised of dislocation (1 case), nonunion of greater trochanter (1 case), infection (1 case) and loosening (1 case), and those in the group B were comprised of loss of fixation (8 cases) and infection (1 case).
CONCLUSION
We found that short-term outcomes of cemented bipolar hemiarthroplasty for unstable intertrochanteric fractures were satisfactory. However, a longer-follow up period is necessary to clarify the efficacy of cemented bipolar hemiarthroplasty.
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Citations
Citations to this article as recorded by  - Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis
Jun-Il Yoo, Yong-Chan Ha, Jae-young Lim, Hyun Kang, Byung-Ho Yoon, Hyunho Kim
Journal of Korean Medical Science.2017; 32(5): 858. CrossRef - The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef
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Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
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Myung Sik Park, Young Jin Lim, Young Sin Kim, Kyu Hyung Kim, Hong Man Cho
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J Korean Fract Soc 2009;22(2):91-97. Published online April 30, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.2.91
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Abstract
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- PURPOSE
To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA).
MATERIALS AND METHODS
We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20~88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12~18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up.
RESULTS
All fractures were united and the mean time to bone union was 15.7 (13~18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (+/-5.65~27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34~2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer.
CONCLUSION
We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.
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Citations
Citations to this article as recorded by - Clinical and radiological outcome of the Chimaera short nailing system in inter- and subtrochanteric fractures
Aurélien Traverso, Trieu-Hoai-Nam Ngo, Guillem Fernandez Gil, Xavier Lannes, Sylvain Steinmetz, Kevin Moerenhout
Injury.2023; 54(3): 970. CrossRef - Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef - The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation
Jong Won Kim, Hyun Soo Park, Young Soo Jang, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae
Journal of the Korean Fracture Society.2012; 25(4): 257. CrossRef - Cementless Bipolar Hemiarthroplasty Using a Rectangular Cross-section Stem for Type A2 or above Intertrochanteric Fractures
Bong-Ju Park, Hong-Man Cho, Cheol Park, Hwang-Se Bong
Hip & Pelvis.2012; 24(3): 222. CrossRef - Hip Arthroplasty for Failed Internal Fixation of Intertrochanteric Fractures
Ju-Oh Kim, Hong-Man Cho, Cheol Park, Ju-Hyun Sim
Hip & Pelvis.2012; 24(2): 94. CrossRef - Anatomical Measurement of Normal Korean Proximal Femur Using Plain Radiography: A Problem when using Proximal Femoral Nail Anti-rotation
Jong-Seok Park, Woo-Jong Kim, Jae-Wan Soh, Byung-Woong Jang, Tae-Heon Kim, You-Sung Suh
Hip & Pelvis.2011; 23(4): 303. CrossRef - The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table
Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho
Journal of the Korean Fracture Society.2011; 24(3): 217. CrossRef - PFNA and PFN in Intertrochanteric Fractures - Comparison Study of Sliding -
Suk Kyu Choo, Hyoung Keun Oh, Jun Young Choi
Hip & Pelvis.2010; 22(1): 79. CrossRef - Proximal Femoral Nail Antirotation versus Compression Hip Screw with Trochanter Stabilizing Plate for Unstable Intertrochanteric Hip Fractures
Jae-Young Rho, Sang-Bum Kim, Youn-Moo Heo, Seong-Jin Cho, Dong-Sik Chae, Woo-Suk Lee
Journal of the Korean Fracture Society.2010; 23(2): 161. CrossRef - Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate
Tae-Ho Kim, Jong-Oh Kim, Seung-Yup Lee, Geon-Ung Yun
Journal of the Korean Fracture Society.2010; 23(4): 353. CrossRef
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