A Comparative Study of Treatment of Unstable Intertrochanteric Fractures with Proximal Femoral Nailing and Cemented Hemiarthroplasty in Elderly Patients

Abstract

Introduction: Intertrochanteric fractures are among the most common fractures seen by orthopedic surgeons. The incidence of these fractures is growing as people live longer lives. The global incidence of hip fractures is predicted to be 1.6 million. Hip fractures consistently result in short- and long-term problems and morbidities.

Aims: The purpose of this study was to evaluate the clinical outcomes of patients who had proximal femoral nailing vs those who had cemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly.

Methods: This is a hospital-based comparative research of senior patients aged 65 and up with unstable intertrochanteric fractures who were admitted to Apollo Hospitals in Bhubaneswar. The sample size was established based on patient availability, and it was set at 25 for proximal femoral nailing and 25 for cemented hemiarthroplasty using the randomisation sampling method before March 2020.After receiving proper consent, patients were evaluated based on their clinical history, clinical examination, surgical procedures, and post-operative rehabilitation.

Results: Cemented hemiarthroplasty for unstable intertrochanteric fractures of the femur in the elderly had a satisfactory early clinical outcome, according to this study. In this study, the 6th and 9th month Harris hip scores were considerably higher in cemented hemiarthroplasty than in proximal femur nailing. Cemented hemiarthroplasty in unstable intertrochanteric fractures has the major advantage of allowing early mobilization, immediate weight bearing with a walker, rapid rehabilitation, shorter hospital stay, and early return to work, so we believe that cemented bipolar hemiarthroplasty is the best option for freely mobile elderly patients over the age of 65 who have an intertrochanteric femoral fracture.

Conclusion: In conclusion, our study found that cemented hemiarthroplasty is a better therapeutic option for older patients with unstable intertrochanteric femoral fractures, particularly those over the age of 65. Several key outcomes showed statistically significant differences: patients undergoing cemented hemiarthroplasty were older, had a higher prevalence of diabetes and hypertension, had longer surgical times, and lost more blood than those receiving proximal femur nailing.