الفهرس 
INTRODUCTION
SURGICAL ANATOMYOnly 14 pages are availabe for public view
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Abstract
BACKGROUND:
Hip fractures are an important cause of increased morbidity and mortality among the elderly population. They are a major threat to the elderly ambulatory function, dependence and even life. The postoperative management should focus on early mobilization to avoid the complications of prolonged recumbency. Primary hip arthroplasty for intertrochanteric fractures have the theoretical advantage of early weight bearing immediately after surgery with no risk of excessive collapse compromising the walking function.
OBJECTIVES:
The aim of the work was to evaluate the results of treatment of unstable intertrochanteric fractures of the femur using cemented Thompson prosthesis followed by early weight bearing in elderly osteoporotic patients.
METHODS:
Elderly patients with three or four part intertrochanteric fractures aged more than 70 years were included in the study. Patients who were previously non-walkers, those with pathological fractures as well as those who had arthritic hips were excluded from the study. A full workup including history, clinical and radiological examination as well as routine laboratory investigations was done for every patient on admission. Data was collected according to a previously prepared sheet and analyzed on SPSS software. The preinjury functional ability score and the preinjury walking aids score was compared to the final postoperative scores. The artificial hip was evaluated by Harris Hip Score.
RESULTS:
The study included 30 patients and 32 hips.Twenty-two patients (24hips=75%) were able to ambulate following surgery and until the end of their follow-up. Out of the 23 patients who survived more than six months, twenty patients (86.95%) were able to walk until the end of follow-up. Out of the 32 hips included, 22(68.75%) were graded as excellent good results according to Harris Hip Score.
CONCLUSIONS:
1. Primary arthroplasty for intertrochanteric fractures allows early safe weight bearing for medically ill elderly patients.
2. The pre-injury functional mobility of the patient is the main predictor of his postoperative functional outcome.
3. The early postoperative ambulation is associated with substantial functional improvement.
4. Primary arthroplasty for unstable intertrochanteric fracture is a reasonable alternative to internal fixation in elderly patients who cannot tolerate prolonged stay in bed.