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KMID : 0361620150500060483
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Journal of the Korean Orthopaedic Association
2015 Volume.50 No. 6 p.483 ~ p.490
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Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femur Fracture in Patients over the Age of 80 Years: Comparative Analysis between Cementless and Cemented Stem
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:Jeon Young-Dae
:Chung So-Hak
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Abstract
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Purpose: The purpose of this study was to evaluate the effectiveness of bipolar hemiarthroplasty for unstable intertrochanteric fracture in patients over the age of 80 years.
Materials and Methods: Sixty-two patients (62 cases) who had unstable comminuted intertrochanteric fractures between January 2007 and February 2012 were evaluated. All patients were over 80 years old at the time of the diagnosis, and were followed-up for at least 12 months. Patients were divided into two groups: those who received cementless stems (group 1, n=32) and those who received cemented stems (group 2, n=30). Functional results including Harris hip score, thigh pain, Koval's ambulatory classification, postoperative mortality rate, operation time, and the amount of blood loss were evaluated.
Results: The operation time and the amount of blood loss were significantly lower in group 1 compared to group 2. The Harris hip score was 82.1±8.6 points for group 1 and 83.4±7.5 points for group 2 at the final follow-up. One patient with poor cement press-fit level in group 2 experienced thigh pain. Twenty-seven patients (84.4%) in group 1 and 25 patients (83.3%) in group 2 recovered pre-injury ambulatory status. During the follow-up period, overall, 6 patients (18.8%) in group 1 and 8 patients (26.7%) in group 2 died. No significant differences in follow-up mortality rates were observed between the two groups.
Conclusion: Considering the satisfactory clinical results, cementless bipolar hemiarthroplasty may be a good treatment option for patients over 80 years old with unstable intertrochanteric fracture.
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KEYWORD
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unstable intertrochanteric fracture, bipolar hemiarthroplasty, cemented, cementless, elderly patients
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