Comparison of Intraoperative and Postoperative Outcomes of Proximal Femoral Nailing and Bipolar Hemiarthroplasty Techniques in Intertrochanteric Femur Fracture Treatment

Abstract

Aim: This study was undertaken with the purpose of comparing the short and long term surgical, clinical, and functional results between bipolar hemiarthroplasty and proximal femoral nailing in the same cohort of patients. Material and Methods: The retrospective scanning of two-year data of a tertiary care hospital has been carried out for patients with hip fractures undergoing proximal femoral nailing and bipolar hemiarthroplasty. 67 patients underwent proximal femoral nailing and 74 patients underwent bipolar hemiarthroplasty were included in the study. Each patient's short and long term outcomes were documented as well as their preoperative, intraoperative, and postoperative features. Results: There were no significant differences in the demographic features of both groups. The median intraoperative blood loss was significantly higher in the group who underwent bipolar hemiarthroplasty compared to the group who underwent proximal femoral nailing (450 cc vs 300 cc, respectively, p<0.001). It was found that the bipolar hemiarthroplasty procedure was associated with a greater need for intraoperative transfusion than the proximal femoral nailing procedure (p=0.007). Intraoperative complications were reported only in patients who underwent bipolar hemiarthroplasty. The need for intensive care unit was significantly higher in the bipolar hemiarthroplasty group than in the proximal femoral nailing group, with the rate of 86.5% (n=64) and 68.7% (n=46), respectively (p=0.011). Conclusion: According to the results of this study, the proximal femoral nailing procedure appears to be a more reliable surgical technique in patients with hip fractures in terms of both intraoperative complications and the postoperative need for an intensive care unit.

Keywords

• elderly
• hemiarthroplasty
• intertrochanteric fracture
• proximal femur nail
• surgery outcome

İntertrokanterik Femur Kırığı Tedavisinde Proksimal Femoral Çivileme ve Bipolar Hemiartroplasti Tekniklerinin İntraoperatif ve Postoperatif Sonuçlarının Karşılaştırılması

Abstract

Amaç: Bu çalışma, benzer özelliklere sahip hasta grubunda bipolar hemiartroplasti ile proksimal femoral çivileme arasında kısa ve uzun dönem cerrahi, klinik ve fonksiyonel sonuçları karşılaştırmak amacıyla yapılmıştır. Gereç ve Yöntemler: Proksimal femur çivileme ve bipolar hemiartroplasti uygulanan kalça kırığı olan hastalar için, üçüncü basamak bir hastanenin iki yıllık verilerinin geriye dönük taraması yapıldı. 67 proksimal femoral çivileme uygulanan hasta ve 74 bipolar hemiartroplasti uygulanan hasta çalışmaya dahil edildi. Her bir hastanın kısa ve uzun vadeli sonuçları ile ameliyat öncesi, ameliyat sırasındaki ve ameliyat sonrası özellikleri kayda alındı. Bulgular: Her iki grubun demografik özelliklerinde istatistiksel olarak anlamlı bir farklılık yoktu. Bipolar hemiartroplasti uygulanan grupta ameliyat sırasındaki ortanca kan kayıp miktarı proksimal femoral çivileme uygulanan gruba göre anlamlı derecede daha yüksekti (sırasıyla 450 cc’ye karşı 350 cc; p<0,001). Bipolar hemiartroplasti prosedürünün, proksimal femoral çivileme prosedüründen daha fazla ameliyat sırasında transfüzyon ihtiyacı ile ilişkili olduğu saptandı (p=0,007). Sadece bipolar hemiartroplasti yapılan hastalarda ameliyat sırasında komplikasyon varlığı rapor edilmiştir. Yoğun bakım ihtiyacı bipolar hemiartroplasti grubunda, proksimal femoral çivileme grubuna göre, sırasıyla %86,5 (n=64) ve %68,7 (n=46) oranları ile anlamlı derecede daha yüksekti (p=0,011). Sonuç: Bu çalışmanın sonuçlarına göre, kalça kırığı olan hastalarda proksimal femoral çivileme prosedürü hem ameliyat sırasındaki komplikasyonlar ve hem de ameliyat sonrası yoğun bakım ihtiyacı açısından daha güvenilir bir cerrahi teknik olarak görünmektedir.

Keywords

• yaşlılar
• hemiartroplasti
• intertrokanterik kırık
• proksimal femur çivileme
• cerrahi sonuçlar

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