Cemented hip hemiarthroplasty clinical observations on unstable intertrochanteric fracture in elderlies

To observe the clinical effect of steel cable or greater trochanter reattachment (GTR) device combined with cemented hip hemiarthroplasty for unstable intertrochanteric fracture in elderlies. From July 2002 to June 2014, a total of 57 elderly patients with unstable intertrochanteric fracture, including 23 males and 34 females, were treated. Their ages ranged from 80 to 95 years, with the average of 83 years. According to Evans-Jensen classification, there were 18 type IIa cases, 13 type IIb cases and 26 type III cases. All patients received cemented bipolar femoral head replacement, using steel cable or GTR device to stabilize the unstable intertrochanteric fracture. All patients had successful operation procedure and were followed up for 36 months. Postoperative X-ray revealed satisfying postoperative position of artificial hip joint, without subsidence or loosening. Three cases with the use of steel cable alone to treat greater trochanter fracture suffered from rupture of steel cable. The patients using GTR device showed good reduction at the site of displaced greater trochanter fracture and a firm fixation. The clinical outcome measured with Harris hip score and Barthel Index at the time of final follow-up was significantly different between the groups. Hip hemiarthroplasty for elderly patients with unstable intertrochanteric fracture can meet the load bearing requirement at early stage and reduce postoperative complications prominently. Moreover, GTR devices can effectively solve the instability problem of posterior-lateral side of hip caused by displacement of greater trochanter in unstable intertrochanteric fracture.