It has been known that the hemiarthroplasty of the hip with bipolar prosthesis is the one of primary treatment methods for management of unstable intertrochanteric hip fracture, especially in severe osteoporotic patients. Additionally this
operative
treatment allows early full weight bearing and has many merits for the patient to return to the preinjury functional level. But we think that this operative method has several considerable points for the more effective treatment technique in
unstable
osteoporotic intertrochanteric fractures. We review the nine intertrochanteric comminuted fracture patients treated with bipolar prosthesis at the Department of Orthopedic Surgery of Ewha Womans University Mok-Dong Hopital form September, 1993 to
June,
1994.
@ES The considered points are as follows:
@EN 1) The difficult problem is to judge the intraoperative head-neck length, which is reduced by the tension of the fascia between gluteus medius and vastus lateralis fascia, preoperative measuring the head-neck length with transparent template,
level
of the tip of greater trochanter and prosthetic femoral head, and range of hip joint under the trial reduction.
2) The operative approach is the other considerable point for the exposure of medial cortical buttress and lesser trochanter in reducing and maintaining principal fragments, and for the accurate anteversion angle of femur.
3) Bipolar hemiarthroplasty technique is not effective in reducing the operative time and the blood loss amount in operative field, especially in comminuted intertrochanteric fracture treatment.
|