Comparison of three methods of greater trochanter fixation in intertrochanteric femur fractures (AO type 31/A2) treated with cementless bipolar hemiarthroplasty

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.

Keywords

• Hip
• intertrochanteric fracture
• hemiarthroplasty
• cementless stem
• greater trochanter
• fracture fixation
• bone plates
• cable

Kaynakça

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