“A Diaphyseal Fitting Modular Bipolar Prosthesis in Comminuted Trochanteric Femur Fracture in Elderly Patient - A Prospective Study”

Abstract

Introduction

The purpose of the study is to assess the management of comminuted trochanteric fractures of femur in elderly patients is tricky as there is challenge of difficult anatomical reduction in osteoporotic bones, need for prolonged immobilization after surgery and more chances of screw cut out in poor quality bone. Prolonged immobilization will lead into complications like bed sores, chest infections, deep vein thrombosis, dependency and psychosocial side effects, increasing both morbidity and mortality. The aim of our study was to evaluate the functional outcome of diaphyseal long stem bipolar prothesis in comminuted trochanteric fractures of femur in elderly patients using Harris Hip Score   

Methodology

This prospective study enrolled 31 patients with unstable intertrochanteric fractures (AO/OTA types 31-A2.2 and 31-A2.3) admitted to the apex trauma center of a tertiary care facility between March 2022 and March 2025. Inclusion criteria comprised treatment with cemented bipolar hemiarthroplasty and a minimum follow-up period of six month.

Results

According to the Harris Hip Score, at the end of 6 months, 7 patients (22.6%) had excellent results, 20 patients (64.5%) had good results, 4 patients (12.9%)) had fair results. With cemented hemiarthroplasty, 87.7% of older patients with unstable intertrochanteric fractures were able to walk sooner, and the results were good.

At 6-month follow-up, Harris Hip Score outcomes demonstrated excellent functional results in 7 patients (22.6%), good results in 20 patients (64.5%), fair results in 4 patients (12.9%). The study revealed that diaphyseal fitting modular bipolar hemiarthroplasty enabled early ambulation in 85.19 % of elderly patients with comminuted trochanteric fractures, with predominantly favorable outcomes overall.

Conclusion

To summarize, employing a diaphyseal fitting modular bipolar prosthesis in older individuals with comminuted trochanteric femur fractures leads to favorable to outstanding functional results along with early mobilization, early weight bearing with rapid rehabilitation with decreased morbidity and mortality.