title: Primary bipolar arthroplasty or total hip arthroplasty for the treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients.
abstract: One hundred independently mobile patients over the age of 75 who had an unstable intertrochanteric or subtrochanteric fracture were treated with primary prosthetic replacement. In all patients a cemented femoral component with diaphyseal support was used. A bipolar arthroplasty was performed in 91 patients and a total hip arthroplasty in 9 patients because of associated coxarthrosis. The functional results according to the Merle d'Aubigné hip rating scale were excellent, very good or good in 78% of the hips. The dislocation rate of 44.5% in the patient group who underwent total hip arthroplasty was significantly higher than the 3.3% in those who had bipolar arthroplasty. Associated with the dislocations was a much higher incidence of pressure sores and pulmonary complications. Adverse effects on the femoral side included 4 cases with progressive loosening of the screws used to fix the greater trochanter to the femoral component, 1 fracture of the distal femur and 1 pseudarthrosis of the bone envelope surrounding the femoral component.
authors.affiliation: Dept. Orthopaedics & Traumatology, A.Z.-V.U.B., Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Haentjens
authors.forename: P P
authors.initials: PP
authors.lastname: Casteleyn
authors.forename: P
authors.initials: P
authors.lastname: Opdecam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods; D004434:Early Ambulation; D005500:Follow-Up Studies; D005684:Gait; D006620:Hip Fractures / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D016059:Range of Motion, Articular