Year 2024,
Volume: 7 Issue: 3, 195 - 199, 30.09.2024
Mehmet Yiğit Gökmen
,
Mesut Uluöz
,
Hasan Orkun Varmış
,
Hakan Çiçek
References
- 1.Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instr Course Lect. 2004;53:441-54.
https://doi.org/10.2106/00004623-200402000-00028
- 2.Haentjens P, Casteleyn PP, De Boeck H, et al. Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation. J Bone Joint Surg Am. 1989;71(8):1214-25.
https://doi.org/10.2106/00004623-198971080-00015
- 3.Green S, Moore T, Proano F. Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly. Clin Orthop Relat Res. 1987;(224):169-77.
https://doi.org/10.1097/00003086-198711000-00024
- 4.Kayali C, Agus H, Ozluk S, et al. Treatment for unstable intertrochanteric fractures in elderly patients: internal fixation versus cone hemiarthroplasty. J Orthop Surg (Hong Kong). 2006;14(3):240-4.
https://doi.org/10.1177/230949900601400302
- 5.Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty. 2002;17(4 Suppl 1):17-22.
https://doi.org/10.1054/arth.2002.33263
- 6.Sun D, Park BS, Jang GI, et al. The Fixation Method according to the Fracture Type of the Greater Trochanter in Unstable Intertrochanteric Fractures Undergoing Arthroplasty. Hip Pelvis. 2017;29(1):62-7.
https://doi.org/10.5371/hp.2017.29.1.62
- 7.Nam HJ, Sun DH, Jang SW. Fixation of Greater Trochanteric Fracture Using Double Strands and Double Loops with Figure of 8 Wiring in Non-cement Total Hip Arthroplasty for Unstable Intertrochanteric Fracture. Hip Pelvis. 2012;24(4):316.
https://doi.org/10.5371/hp.2012.24.4.316
- 8.Cho HM, Lee SR, Park MS, et al. Standard Type Cemented Hemiarthroplasty with Double Loop and Tension Band Wiring for Unstable Intertrochanteric Fractures in the Elderly. J Korean Hip Soc. 2010;22(2):159.
https://doi.org/10.5371/jkhs.2010.22.2.159
- 9.Kim IS, Pansey N, Kansay RK, et al. Greater Trochanteric Reattachment Using the Third-Generation Cable Plate System in Revision Total Hip Arthroplasty. J Arthroplasty. 2017;32(6):1965-9.
https://doi.org/10.1016/j.arth.2017.01.017
- 10.Huang G, Zhang M, Qu Z, et al. Fixation options for reconstruction of the greater trochanter in unstable intertrochanteric fracture with arthroplasty. Medicine. 2021;100(26):e26395.
https://doi.org/10.1097/MD.0000000000026395
- 11.Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-55.
https://doi.org/10.2106/00004623-196951040-00012
- 12.Tang J, Wu T, Shao H, et al. Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up. International Orthopaedics (SICOT). 2022;46(11):2553-60.
https://doi.org/10.1007/s00264-022-05538-3
- 13.Plausinis D, Speirs AD, Masri BA, et al. Fixation of trochanteric slide osteotomies: a biomechanical study. Clin Biomech (Bristol, Avon). 2003;18(9):856-63.
https://doi.org/10.1016/s0268-0033(03)00148-7
- 14.14. Zhu Z, Ding H, Shao H, Zhou Y, et al. An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA. J Orthop Surg Res. 2013;8(1):7.
https://doi.org/10.1186/1749-799X-8-7
- 15.Feng JN, Zhang CG, Li BH, et al. Global burden of hip fracture: The Global Burden of Disease Study. Osteoporos Int. 2024;35(1):41-52.
https://doi.org/10.1007/s00198-023-06907-3
- 16.Hagino H, Nakamura T, Sakamoto K, et al. Nationwide survey of hip fractures in Japan. Journal of Orthopaedic Science. 2004;9(1):1-5.
https://doi.org/10.1007/s00776-003-0741-8
- 17.Zaib J, Madni A, Saad Azhar M. Predictive Value of Comprehensive Geriatric Assessment Scores for Mortality in Patients with Hip Fracture: A Retrospective Cohort Study. Cureus. Published online September 11, 2023.
https://doi.org/10.7759/cureus.45070
- 18.White SM. A retrospective, observational, single-centre, cohort database analysis of the haemodynamic effects of low-dose spinal anaesthesia for hip fracture surgery. BJA Open. 2024;9:100261.
https://doi.org/10.1016/j.bjao.2024.100261
- 19.Patel S, Soler JA, El-Husseiny M, et al. Trochanteric Fixation Using a Third-Generation Cable Device—Minimum Follow-Up of 3 Years. The Journal of Arthroplasty. 2012;27(3):477-81.
https://doi.org/10.1016/j.arth.2011.06.032
- 20.Zhang H, Xu Z, Zhou A, et al. Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture: A 2-to-11-year follow-up. Medicine (Baltimore). 2017;96(1):e5614.
https://doi.org/10.1097/MD.0000000000005614
- 21.Grimsrud C, Monzon RJ, Richman J, et al. Cemented hip arthroplasty with a novel cerclage cable technique for unstable intertrochanteric hip fractures. J Arthroplasty. 2005;20(3):337-43.
https://doi.org/10.1016/j.arth.2004.04.017
- 22.Ozan F, Koyuncu S, Pekedis M, et al. Greater trochanteric fixation using a cable system for partial hip arthroplasty: a clinical and finite element analysis. Biomed Res Int. 2014;2014:931537.
https://doi.org/10.1155/2014/931537
- 23.Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res. 2000;(371):206-15.
https://doi.org/10.1097/00003086-200002000-00025
- 24.Haentjens P, Casteleyn PP, Opdecam P. Primary bipolar arthroplasty or total hip arthroplasty for the treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Acta Orthop Belg. 1994;60 Suppl 1:124-8.
- 25.Stern MB, Angerman A. Comminuted intertrochanteric fractures treated with a Leinbach prosthesis. Clin Orthop Relat Res. 1987;(218):75-80.
https://doi.org/10.1097/00003086-198705000-00012
Comparison of three methods of greater trochanter fixation in intertrochanteric femur fractures (AO type 31/A2) treated with cementless bipolar hemiarthroplasty
Year 2024,
Volume: 7 Issue: 3, 195 - 199, 30.09.2024
Mehmet Yiğit Gökmen
,
Mesut Uluöz
,
Hasan Orkun Varmış
,
Hakan Çiçek
Abstract
Aim: The aim of this study was to compare the three most commonly used fixation methods for the fractured trochanter major fragment in patients undergoing uncemented bipolar hemiarthroplasty for unstable intertrochanteric fractures.
Methods: The medical records of 231 acute hip fracture cases aged 65 years and older with AO classification 31/A2.2 and 31/A2.3 who underwent unilateral primary cementless bipolar hemiarthroplasty at Adana Şehir Training and Research Hospital between January 2021 and January 2023 were retrospectively analyzed. The files were classified into three groups based on the fixation technique used in the operation.
Results: There were 231 files, with a mean age of 82.3±7.9. The majority (55.8%) were classified as ASA III. The analysis resulted in no significant differences between the groups in terms of age, number of days between the day of the injury and the day of the surgery, fixation failure, nonunion, number of revision surgeries, hospitalization duration, and HHS recorded at the third and sixth-month follow-up visits. Among the 73 males and 158 females, the ratio of the side in which the fracture occurred showed no difference (p=0.854). The female rate was significantly higher in group 3 compared to other groups (p=0.003). Regarding union success, cases in group 1 had significantly lower trochanter major union rates (p<0.001).
Conclusions: This study demonstrated that in patients treated with cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures, union rates were significantly higher when fixated using trochanteric grip plates.
Ethical Statement
Ethical permission was obtained from the Adana City Training and Research Hospital Clinical / Human Research Ethics Committee for this study date on May 11, 2023, and decision number 2549 and Helsinki Declaration rules were followed to conduct this study.
Supporting Institution
Adana City Training and Research Hospital Clinical / Human Research Ethics Committee
References
- 1.Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instr Course Lect. 2004;53:441-54.
https://doi.org/10.2106/00004623-200402000-00028
- 2.Haentjens P, Casteleyn PP, De Boeck H, et al. Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation. J Bone Joint Surg Am. 1989;71(8):1214-25.
https://doi.org/10.2106/00004623-198971080-00015
- 3.Green S, Moore T, Proano F. Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly. Clin Orthop Relat Res. 1987;(224):169-77.
https://doi.org/10.1097/00003086-198711000-00024
- 4.Kayali C, Agus H, Ozluk S, et al. Treatment for unstable intertrochanteric fractures in elderly patients: internal fixation versus cone hemiarthroplasty. J Orthop Surg (Hong Kong). 2006;14(3):240-4.
https://doi.org/10.1177/230949900601400302
- 5.Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty. 2002;17(4 Suppl 1):17-22.
https://doi.org/10.1054/arth.2002.33263
- 6.Sun D, Park BS, Jang GI, et al. The Fixation Method according to the Fracture Type of the Greater Trochanter in Unstable Intertrochanteric Fractures Undergoing Arthroplasty. Hip Pelvis. 2017;29(1):62-7.
https://doi.org/10.5371/hp.2017.29.1.62
- 7.Nam HJ, Sun DH, Jang SW. Fixation of Greater Trochanteric Fracture Using Double Strands and Double Loops with Figure of 8 Wiring in Non-cement Total Hip Arthroplasty for Unstable Intertrochanteric Fracture. Hip Pelvis. 2012;24(4):316.
https://doi.org/10.5371/hp.2012.24.4.316
- 8.Cho HM, Lee SR, Park MS, et al. Standard Type Cemented Hemiarthroplasty with Double Loop and Tension Band Wiring for Unstable Intertrochanteric Fractures in the Elderly. J Korean Hip Soc. 2010;22(2):159.
https://doi.org/10.5371/jkhs.2010.22.2.159
- 9.Kim IS, Pansey N, Kansay RK, et al. Greater Trochanteric Reattachment Using the Third-Generation Cable Plate System in Revision Total Hip Arthroplasty. J Arthroplasty. 2017;32(6):1965-9.
https://doi.org/10.1016/j.arth.2017.01.017
- 10.Huang G, Zhang M, Qu Z, et al. Fixation options for reconstruction of the greater trochanter in unstable intertrochanteric fracture with arthroplasty. Medicine. 2021;100(26):e26395.
https://doi.org/10.1097/MD.0000000000026395
- 11.Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-55.
https://doi.org/10.2106/00004623-196951040-00012
- 12.Tang J, Wu T, Shao H, et al. Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up. International Orthopaedics (SICOT). 2022;46(11):2553-60.
https://doi.org/10.1007/s00264-022-05538-3
- 13.Plausinis D, Speirs AD, Masri BA, et al. Fixation of trochanteric slide osteotomies: a biomechanical study. Clin Biomech (Bristol, Avon). 2003;18(9):856-63.
https://doi.org/10.1016/s0268-0033(03)00148-7
- 14.14. Zhu Z, Ding H, Shao H, Zhou Y, et al. An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA. J Orthop Surg Res. 2013;8(1):7.
https://doi.org/10.1186/1749-799X-8-7
- 15.Feng JN, Zhang CG, Li BH, et al. Global burden of hip fracture: The Global Burden of Disease Study. Osteoporos Int. 2024;35(1):41-52.
https://doi.org/10.1007/s00198-023-06907-3
- 16.Hagino H, Nakamura T, Sakamoto K, et al. Nationwide survey of hip fractures in Japan. Journal of Orthopaedic Science. 2004;9(1):1-5.
https://doi.org/10.1007/s00776-003-0741-8
- 17.Zaib J, Madni A, Saad Azhar M. Predictive Value of Comprehensive Geriatric Assessment Scores for Mortality in Patients with Hip Fracture: A Retrospective Cohort Study. Cureus. Published online September 11, 2023.
https://doi.org/10.7759/cureus.45070
- 18.White SM. A retrospective, observational, single-centre, cohort database analysis of the haemodynamic effects of low-dose spinal anaesthesia for hip fracture surgery. BJA Open. 2024;9:100261.
https://doi.org/10.1016/j.bjao.2024.100261
- 19.Patel S, Soler JA, El-Husseiny M, et al. Trochanteric Fixation Using a Third-Generation Cable Device—Minimum Follow-Up of 3 Years. The Journal of Arthroplasty. 2012;27(3):477-81.
https://doi.org/10.1016/j.arth.2011.06.032
- 20.Zhang H, Xu Z, Zhou A, et al. Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture: A 2-to-11-year follow-up. Medicine (Baltimore). 2017;96(1):e5614.
https://doi.org/10.1097/MD.0000000000005614
- 21.Grimsrud C, Monzon RJ, Richman J, et al. Cemented hip arthroplasty with a novel cerclage cable technique for unstable intertrochanteric hip fractures. J Arthroplasty. 2005;20(3):337-43.
https://doi.org/10.1016/j.arth.2004.04.017
- 22.Ozan F, Koyuncu S, Pekedis M, et al. Greater trochanteric fixation using a cable system for partial hip arthroplasty: a clinical and finite element analysis. Biomed Res Int. 2014;2014:931537.
https://doi.org/10.1155/2014/931537
- 23.Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res. 2000;(371):206-15.
https://doi.org/10.1097/00003086-200002000-00025
- 24.Haentjens P, Casteleyn PP, Opdecam P. Primary bipolar arthroplasty or total hip arthroplasty for the treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Acta Orthop Belg. 1994;60 Suppl 1:124-8.
- 25.Stern MB, Angerman A. Comminuted intertrochanteric fractures treated with a Leinbach prosthesis. Clin Orthop Relat Res. 1987;(218):75-80.
https://doi.org/10.1097/00003086-198705000-00012