Comparison of Hemiarthroplasty and Fixation in Unstable Intertrochanteric Fracture in Older Age
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 1
Abstract
Background and Objectives: For many decades, attempts have been made to overcome the difficulties which surgeons encounter in the treatment of proximal femoral fractures. Extra medullary and intramedullary implants have improved in recent years, although consensus is lacking concerning the definition and classification of unstable intertrochanteric fractures, with uncertainties regarding treatment. In this era of technologically sound and tested fixation methods we shall compare functional outcomes and complications of various methods available for unstable it fracture fixation. The purpose of this study is to analyze the role of primary hemi arthroplasty in cases of unstable osteoporotic intertrochanteric femur fractures and compare the outcomes with conventional fixation techniques to find out a better management plan for the patient. Materials and Methods: This is a prospective study of fifty cases of unstable intertrochanteric fractures, either treated with primary replacement (hemi or total) or fixation. Between February 2015 and December 2015, fifty patients with an unstable comminuted intertrochanteric femoral fracture (AO/OTA type 31A2.2, A2.3, A3.2, A3.3) were enrolled in the study, which was approved by our institutional review board. Results: Maximum patients (88%) belonged to 60-80 years of age. Since most of the patient belong to elderly age group, medical comorbidities are very common. Average requirement of blood transfusion needed was significantly higher in hemi replacement group than in fixation group. (Z= 3.56, p<0.05). This indicated the surgical complexity of hemi replacement. There was significant shortening of limb in fixation group as compared to hemi replacement. (Z=6.98,p value <0.05). Thus hemi replacement provided faster rehabilitation to the patient. This implies that those patients who had hemi replacement had a significantly better activity of daily living. Harris hip scores were significantly better in hemi replacement group. (Z=4.31, p value<0.05) suggesting better functional outcomes. There was no significant difference between immediate postoperative complications though skin incision, operating time, and blood loss were significantly higher in hemi replacement group.(Z=0.7, p>0.05) but the rate of delayed complications and revision surgeries were significantly higher in fixation group. (p<0.05) There was no significant difference in mortality rates of both groups despite more blood loss and duration of surgeries in hemi replacement group. Conclusion: In conclusion we state that hemi replacement arthroplasty, is a valid treatment option for mobile and mentally healthy patients, as compared to fixation for faster rehabilitation and better activity of daily living.
Authors and Affiliations
Sandip R. Rathod, Vivek L. Patel, Piyush N. Parikh, Rishikumar A. Solanki, Parth N. Patel
Keywords
Related Articles
- EP ID EP531328
- DOI 10.21276/ijmrp.2018.4.1.135
- Views 100
- Downloads 0
Incidence and Severity of Oral Mucositis in Patients of Head and Neck Cancers Receiving Definitive Radiotherapy with or without Chemotherapy: A Hospital Based Study
Background: Head and neck cancers are among the ten most frequent cancers in the world and constitute 5% of all cancers worldwide. In developing countries like ours, cancer of the head and neck is among one of the common...
A Clinical Audit of Fresh Frozen Plasma request in a Tertiary Care Hospital Of North-Western India
Introduction: Clinical audit of Fresh Frozen Plasma (FFP) uses is having a major role in improving the quality of transfusion services, as patients receiving Fresh Frozen Plasma unnecessarily will have the risk of allerg...
Relationship between Asthma and Obesity in Pediatric Age from Four Years to Four Teen Years in Tabuk City
Introduction: Asthma is the most common heterogeneous chronic disorder of the airways, characterized by variable usually reversible and recurring symptoms of cough, wheezing, shortness of breath, and chest tightness rela...
Assessment of Incidence of Bacterial Pathogens Causing Ocular Infections: An Observational Study
Background: Bacteria contribute for major etiologic component for ocular pathologies. Bacterial conjunctivitis is commonly seen in children and the elders but can also be presented among neonates and adults. Hence; we pl...
A Prospective Observational Study to Correlation of Sign & Symptoms of Articular and Abarticular with Type 2 Diabetes Mellitus Patients
Background: Diabetes mellitus leads to various complication ranging from microvascular, autonomic to cerebrovascular disease. Every organ of body is affected by the disease. The aim of this study to correlate of sign & s...