Calcar Femorale Grafting In the cemented Bipolar Hemiarthroplasty of the Hip for Unstable Intertrochanteric Fractures Using Posterolateral Approach
Keywords:
Fracture femur, Calcar, Hemiarthroplasty, Unstable, IntertrochantericAbstract
Background: Unstable intertrochanteric fractures are associated with a high rate of complications and poses difficulty in fixation. Calcar femorale cemented bipolar hemiarthropalsty may be a suitable treatment in these patients. The aim of this study is to assess the clinical and functional results of the use of such a prosthesis in old patients with an unstable intertrochanteric fracture of the femur. Patients & Methods: We have presented a simple & effective technique of calcar grafting by harvesting cortical bone strut from the neck of the fractured femur. Fifty patients were included in this prospective study. All the patients had unstable intertrochanteric fractures. Only patients with type III, IV or type V fractures according to the Evans classification were included in the study. Functional & radiological results were assessed after a mean follow up period of 18 months. Results: At the end of the study, only 42 patients were available for evaluation. The mean follow-up period was 18 months (range, 16–24 months). At the last follow-up, the mean Harris hip score was 85 points. Radiologically, all stems were stable, without significant changes in alignment or progressive subsidence. No infection or thromboembolic complications were encountered. Conclusion: Calcar femorale cemented bipolar hemiarthroplasty is a good option for unstable intertrochanteric fractures in the elderly. It allows early weight bearing and rapid return to prefracture activity and does not have the difficulty and complications of internal fixation of this complex fracture.
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