Hemiarthroplasty as a Viable Option for Unstable Intertrochanteric Femur Fractures in the Elderly: A Functional Outcome Analysis.

BACKGROUND

Unstable intertrochanteric femur fractures in elderly osteoporotic patients are associated with high morbidity and mortality. While internal fixation remains the standard treatment, fixation failure and prolonged immobilisation are frequent concerns. Primary cemented bipolar hemiarthroplasty offers the potential for immediate stability and early mobilisation, reducing postoperative complications.

METHODS

This prospective study included 30 elderly patients (>60 years) with unstable intertrochanteric fractures treated with primary cemented bipolar hemiarthroplasty from June 2021 to August 2024. Functional and radiological outcomes were assessed using the Harris Hip Score and radiograph at regular intervals.

RESULTS

The mean operative time was 81 minutes with an average blood loss of 361.03 ml. Full weight-bearing was achieved at a mean of 3.2 days postoperatively. At one year, 76% of patients demonstrated fair to excellent outcomes on the Harris Hip Score. Limb length discrepancy (<2 cm) was noted in 10 cases, primarily due to prosthetic subsidence from calcar loss. The overall mortality rate was 16.6%, with all deaths occurring due to causes unrelated to surgery. No cases of dislocation were observed.

CONCLUSION

Primary cemented bipolar hemiarthroplasty is a safe and effective option for managing unstable intertrochanteric femur fractures in elderly osteoporotic patients. It allows early mobilisation, restores function, and minimises complications related to prolonged recumbency. Larger comparative studies with longer follow-up are needed to further validate its long-term efficacy over internal fixation.