الفهرس 
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Abstract
Fractures of the proximal part of the femur in elderly patients are generally the results of a single fall and are more common in women than men. Unstable intertrochanteric fractures in elderly constitute one of the major disabling morbidity in this age group.
People in this age group usually have other systemic diseases such as diabetes, cardiovascular diseases. The impact of these diseases cause rapid deterioration of the general condition of those patients especially in the bed ridden condition. The main goals in the treatment of these patients are to restore the pre-fracture activity status of the patients, to allow early full weight bearing, and try to avoid possible second operation to correct one of the complications of the treatment.
As a general rule, preservation of the natural bones to the patient is the ideal aim of the surgeons. In osteoporotic elderly patients with unstable intertrochanteric fracture this ideal aim will not help the patient to restore back his activity if internal fixation was done. Weak purchase of the internal fixation device (whatever its type) due osteoporosis and comminution of the fracture site increase the incidence of failure of internal fixation e.g. cutting throw of the screws, displacement of the bone fragments.
There is no internal fixation device that allows early full weight bearing of patient with severe osteoporosis and marked comminution at the fracture site. Partial weight bearing is very difficult to be controlled by these patients, so they may shift to full weight bearing on the operated limb causing metal or bone failure.
Cemented prosthesis will allow immediate full weight bearing, easy rehabilitation program, incidence of pressure sores, pulmonary
Summary
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infection and atlectasis were significantly low. This will help the patient to restore back his level of activity instead of sitting in the bed and toe touch walking.
This study was conducted a prospectively on 20 patients. The inclusion criteria are:
1) Unstable intertrochanteric fractures.
2) Elderly patient (60 years or older).
3) Osteoporosis (Singh index 4, 3,2,&1).
There were some complication in this series; 1 case of infection, 1 case of dislocation, 1 case of intra-operative crack.
With comparison of the results of this study to the results of similar studies and it was found that the results of this study were similar to their results in most of the tested points.
So, Bipolar hemiarthroplasty should be considered as one of the modalities of the treatment of Unstable intertrochanteric fractures in elderly.