Calcar Replacement Hemiarthroplasty versus Proximal Femoral Nail for Treatment of Unstable Intertrochanteric Fractures in Elderly

Document Type : Original Article

Authors

Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Intertrochanteric fractures occur with low-energy trauma because of decreased bone quality and deterioration of histological structure based on osteoporosis. The aim of this work was to compare proximal femoral nail and calcar-replacement hemiarthroplasty in treatment of unstable intertrochanteric fractures of elderly regarding the surgical techniques, clinical and radiological outcomes, complications [intra- and post- operative], functional hip outcome and patient satisfaction.
Patients and Methods: This Prospective Randomized Study was conducted on Thirty patients with unstable intertrochanteric hip fracture. Patients were divided into two equal groups: Group I was treated with bipolar calcar hemiarthroplasty, and Group II were treated with a proximal femoral nail.
Results: At 3 months, Harris’ hip score was significantly higher in hemiarthroplasty group [p < 0.001*]. However, at 6 months and 12 months, the differences in scores were not statistically significant [p > 0.05]. At 24-month Harris hip score was significantly higher in PFN group then hemiarthroplasty group [p=0.04]. The mean duration of surgery was significantly shorter in the PFN group compared to the Hemiarthroplasty group [p = 0.041]. The mean blood loss during surgery was significantly lower in the PFN group compared to the Hemiarthroplasty group [p<0.001].
Conclusion: PFN and calcar-replacement hemiarthroplasty are two safe and effective fixation methods for treating the elderly with intertrochanteric fractures.  Both PFN and calcar-replacement hemiarthroplasty achieve stable fracture fixation, reduce pain, less post-operative complications and restore function of the hip joint.

Keywords

Main Subjects

Files

Share

How to cite

Statistics