Cemented Bipolar Hemiarthroplasty with a Wiring Technique for Unstable Intertrochanteric Hip Fractures in Elderly Patients

Abstract

Purpose: Intertrochanteric hip fractures are commonly seen in the elderly population. Osteosynthesis is technically demanding and has a high rate of failure, especially in osteoporotic bones. Furthermore, delayed ambulation after surgery can be a risk factor for systemic complications. Active prevention of prolonged bed-ridden can improve the quality of life postoperatively. For early ambulation, the authors chose hemiarthroplasty as the surgical method. The purpose of this study was to assess the efficacy of cemented bipolar hemiarthroplasty with a wiring technique for unstable intertrochanteric hip fractures in the elderly. Materials and Methods: A retrospective review was conducted on the records of 41 patients with unstable intertrochanteric hip fractures treated with cemented bipolar hemiarthroplasty between January 2019 and December 2022. The mean patient age was 82 years, and cemented bipolar hemiarthroplasty with a wiring technique was performed in all cases. Clinical and radiologic outcomes were analyzed. The rate of complications and modified Harris hip score (HHS) at one-year follow-up were reviewed. Results: Early ambulation was initiated at a mean of 7.8 days postoperatively. Eight patients had systemic complications but recovered prior to discharge. There were no complications of loosening, dislocation, or infection indicated at the minimum one-year postsurgical follow-up. The mean modified HHS was 75.8. Conclusion: Cemented bipolar hemiarthroplasty with a wiring technique showed positive clinical results in the treatment of unstable intertrochanteric hip fractures in elderly patients with osteoporosis. Furthermore, early ambulation could prevent recumbency-related complications. As a result, this technique is considered a good surgical alternative for an aging population.