The purpose of this study was to evaluate the clinical and radiologic results of a consecutive series of Wagner SL arthroplasties in patients with unstable intertrochanteric osteoporotic fractures. Forty-seven consecutive arthroplasties for unstable intertrochanteric fractures using Wagner SL hip stems were studied. All patients had bone mineral density less than -2.5 SD. At average follow-up of 2.7years, mean Harris Hip Scores were 89.4 (range, 65-100) and 87.7 (range, 57-100) for total hip arthroplasties and hemiarthroplasties, respectively. Twenty-one patients (53.8%) had excellent Harris Hip Scores (>90, 14 [35.9%]). Evidence of clinical and radiologic healing was first noted at a mean follow-up of 3.7months (3-5months). Wagner SL hip arthroplasties for unstable intertrochanteric osteoporotic fractures have favourable short-term clinical and radiological outcomes.
[Show abstract][Hide abstract] ABSTRACT: Purpose
This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys.
Materials and Methods
Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score. Retrospective evaluation was performed by operative time, transfusion amount, time to operation days, hospital stay and time to full weight bearing. Clinically, ambulatory ability was checked by Parker and Palmer (P&P) score and function of hip was appraised by Harris hip score (HSS). Radiologically, bone healing of fractured trochanteric fragment and presence of subsidence, stress shielding or osteolysis were checked.
Fracture type was 11 cases of A2.2, 18 cases of A2.3 and 6 cases of A3.3. Femoral stems used were 8 cases of rectangular tapered wedge type and 27 cases of fluted modular distal fixation type. P&P score improved from mean preinjury score of 7.1 to mean postoperative last follow-up score of 6.5. Median HHS at last follow-up was 75. Mean time to full weight bearing was 47 days (24-79 days). Postoperative complications were one case of linear periprosthetic femoral fracture and one case of postoperative dislocation.
Cementless hip replacement arthroplasty could be a good option for unstable intertrochanteric femoral fracture in elderlys.
Keywords: Hip, Intertrochanteric femur fracutre, Hip replacement arthroplasty.
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B. L. Gray, J. B. Stambough, G. R. Baca, P. L. Schoenecker, J. C. Clohisy
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