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ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2009, Number 6

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Acta Ortop Mex 2009; 23 (6)

Cemented femoral prosthesis with calcar replacement for intertrochanteric hip fractures in the elderly

García JJD, Tohen BA, García HA, Dávila SO

Language: Spanish
References: 15
Page: 326-330
PDF size: 85.49 Kb.


ABSTRACT

Introduction: The increase in hip fractures among the elderly and the presence of intercurrent diseases makes it necessary to institute treatments that help patients resume their activities as soon as possible. Objective: Analyze the clinical course of patients with a cemented femoral endoprosthesis with calcar replacement and determine the time to resuming walking. Material and methods: 18 patients were seen from January 2003 to December 2006, all of them with a diagnosis of Tronzo T IV and V intertrochanteric hip fractures, over 70 years of age and treated primarily with a cemented femoral endoprosthesis with calcar replacement. Results: The total number of patients was 18, 14 females (77.77%) and 4 males (22.22%). The fracture types were: Tronzo grade IV in 11 patients and grade V in 7 patients; mean age was 78 years and their functional capacity in the immediate postoperative period was: onset of walking with full weightbearing at 48 hours in 100% of patients. Return to usual activities occurred at 4 weeks in 17 patients (94.44%). Conclusions: Due to the complexity of these fractures and the patients’ bone quality, there are limited chances to treat them with osteosynthesis, as the latter would increase patients’ morbidity and mortality. Patients could undergo early rehabilitation.


REFERENCES

  1. Berend KR, Hanna J, Smith TM: Acute hip arthroplasty for the treatment of Intertrochanteric fractures in the elderly. J Surg Orthop Adv 2005; 14(4): 185-9.

  2. Schuckmann P, Schuckmann W: Indications for endoprosthetic management of pertrochanteric fractures. Beitr Orthop Traumatol 1989; 36(6): 279-82.

  3. Kim SY, Kim YG, Hwang JK: Cementless calcar-replacement hemiarthroplasty compared with intramedullary fixation of unstable intertrochanteric fractures. A prospective, randomized study. J Bone Joint Surg Am 2005; 87(10): 2186-92.

  4. Haentjens P, Lamrasky G: Endoprosthetic replacement of unstable, comminuted intertrochanteric fracture of the femur in the elderly, osteoporotic patients: a review. Disabil Rehabil 2005; 27(18-19):1167-80.

  5. Tucci M, Scharplatz D. Postoperative stress on by dynamic hip screw or endoprosthesis treated femoral neck and pertrochanteric femoral fractures in elderly patients. Swiss Surg 1996; 2: 67-71.

  6. Parker MJ, Gurusamy K: Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev 2006; 3: CD001706.

  7. Hernigou P, Poignard A, Mathieu G: Total hip arthroplasty after failure of per-and subtrochanteric fracture in elderly subjects. Rev Chrir Orthop Reparatrice Appar Mot 2006; 92(4): 310-5.

  8. Winemaker M, Gamble P, Petruccelli D: Short-term outcomes of total hip arthroplasty after complications of open reduction internal fixation for hip fracture. J Arthroplasty 2006; 21(5): 682-8.

  9. Dobbs RE, Parvizi J, Lewallen DG. Perioperative morbidity and 30-day mortality after intertrochanteric hip fractures treated by internal fixation or arthroplasty. J Arthroplasty 2005; 20(8): 963-6.

  10. Waddell JP, Morton J, Schemistsch EH: The role of total hip replacement in intertrochanteric fractures of the femur. Clin Orthop Relat Res 2004; 429: 49-53.

  11. Liang YT, Tang PF, Guo YZ, Tao S: Clinical research of hemiprosthesis arthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients. Zhonghua Yi Xue Za Zhi 2005; 85(46): 3260-2.

  12. Thorngren KG, Norman PO, Hommel A: Influence of age, sex, fracture type and pre-fracture living on rehabilitation pattern after hip fracture in the elderly. Disabil Rehabil 2005; 27(18-19): 1091-7.

  13. Jackman JM: New techniques in hip fractures management. Mol Med 2005; 102(3): 231-5.

  14. Kesmezacar H, Ogut T, Bilgili MG: Treatment of intertrochanteric femur fractures in elderly patients: internal fixation on hemiarthroplasty. Acta Orthop Traumatol Turc 2005; 39(4): 287-94.

  15. Rogmark C, Johnell O: Primary arthroplasty is better than internal fixation of displaced femoral neck fractures: a meta-analysis of 14 randomized studies with 2,289 patients. Acta Orthop 2006; 77(5); 836.




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