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العنوان
Outcome of Internal Fixation by Cephalomedullary nail Versus Outcome of Bipolar Hemiarthroplasty in the treatment of Unstable Pertrochanteric Femoral Fractures in Elderly:
Systematic Review and Meta-analysis
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المؤلف
Ibrahim,Ibrahim Abdelwahab .
هيئة الاعداد
باحث / إبراهيم عبدالوهاب إبراهيم
مشرف / محمد عبدالمنعم الجبيلي
مشرف / محمد على ابراهيم
تاريخ النشر
2023
عدد الصفحات
128.p;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة العظام والطب الرياضي
تاريخ الإجازة
1/1/2023
مكان الإجازة
جامعة عين شمس - كلية الطب - Orthopaedic Surgery
الفهرس
Only 14 pages are availabe for public view

from 129

from 129

Abstract

Intertrochanteric femur fIntroduction
It is frequently challenging to treat an unstable intertrochanteric fracture in elderly people by internal fixation because of difficult anatomical reduction, poor bone quality, the need for prolonged bed rest and restricted ambulation. As an alternative to internal fixation, cemented bipolar hemiarthroplasty has been used as a treatment for unstable intertrochanteric fractures to avoid the postoperative immobilization-related complications. The aim of this study was to evaluate the functional and clinical outcomes of primary cemented bipolar hemiarthroplasty for elderly patients with unstable intertrochanteric fractures.
Methodology
A prospective study was conducted that included 30 patients who were admitted to the apex trauma center at a tertiary care center from January 2019 to August 2020 with unstable intertrochanteric fractures (Association for Osteosynthesis/Orthopaedic Trauma Association, or AO/OTA, types 31-A2.2 and 31-A2.3); patients treated with cemented bipolar hemiarthroplasty, with at least one year of follow-up were included in the study. Basic descriptive statistics were used and the results were presented in frequencies, percentages for categorical variables and means and standard deviations for continuous variables.
Results
According to the Harris Hip Score, at the end of 12 months, 9 patients (30%) had excellent results, 14 patients (46.67%) had good results, 5 patients (16.67) had fair results, and 2 cases (6.67) had poor results. With cemented hemiarthroplasty, 87.7% of older patients with unstable intertrochanteric fractures were able to walk sooner, and the results were good.
Conclusion
Hemiarthroplasty of the hip with a cemented bipolar prosthesis appears to be a reliable treatment method for the management of unstable intertrochanteric fractures in elderly patients with osteoporosis; it allows for early ambulation and leads to a favorable functional outcome in most patients following surgery.
ractures, the most common type of fragility fractures in the elderly, account for 55% of proximal femoral fractures. As life expectancy and the global elderly population increase, the incidence of hip fractures in the elderly, especially intertrochanteric fractures, will continue to increase. Intertrochanteric femur fractures have high fatality and disability rates, resulting in a huge burden on the economy and on society.
We performed this meta-analysis to compare the advantages and disadvantages of the PFN and BHA to provide reliable evidence for clinicians in selecting the optimal treatment for unstable intertrochanteric fractures