Comparative study of outcomes in communited extracapsular fractures of hip treated with cemented bipolar arthroplasty and dynamic hip screw techniques
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 9, Issue 1
Abstract
Background: Injuries like inter trochantric factures is a common problem in the elderly. The management of communited intertrochanteric fracture is challenging because of excessive collapse, loss of fixation and cut off of the lag screw resulting in poor fixation. Present study has been undertaken to evaluate the functional outcome of communited intertrochanteric fractures with cemented bipolar arthroplasty compared with dynamic hip screw fixation. Objectives: To compare the results, efficacy in meeting the activities of daily routine, functional and clinical outcomes of cemented bipolar anddynamic hip screw fixation as a treatment for comminuted intertrochanteric fractures in elderly patients. Methodology: This prospective study was conductd on 32 cases of intertrochanteric fractures of hip, 16 cases treated with cemented bipolar hemiarthroplasty and 16 cases with Dynamic Hip Screw. The cases were classified according to AO:OTA classification. Hardinge’s modification of antero: lateral approach was used for cemented bipolar cases and lateral approach was used for dynamic hip screw fixation. Pre operative care, inter operative care, post operative care & complications during follow up period were observed. Functional evaluation was done by using Haris Hip Score and data was analysed. Result and conclusion: In a present study, age group ranges for patient was from 60 to 75 years & 56.17% were male & 43.75% were female. Harris Hip Score in cemented bipolar showed 6 (37.5%) excellent, 6 (37.5%) good, 4 (25%) fair results while dynamic hip screw showed 4 (25%) excellent, 6(37.5%) good, 2(12.5%) fair and 4 (25%) poor results. Complications noted in the study of cemented bipolar were 1(6.25%) case of superficial wound infection, 4 (25%) cases of shortening and 6 (37.5%) cases of abductor weakness with Trendelenburg gait while in study of dynamic hip screw were 4(25%) cases of implant failure, 3 (18.75%) cases of non:union, 2(12.5%) cases of knee stiffness and 4 (25%) cases of varus angulation and 1(6.25%) case died due to medical reasons. This study concludes that primarily the cemented bipolar arthroplasty can be considered as one the main treatment option in communited intertrochanteric fractures in elders.
Authors and Affiliations
Zeeshan Muzahid T
Keywords
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- EP ID EP465587
- DOI 10.26611/1020912
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