Bipolar Hemiarthroplasty should not be selected as the primary option for intertrochanteric fractures in elderly patients

Abstract

AbstractIntertrochanteric fractures (ITFs) in the elderly are still a big challenge for clinical doctors. Although proximal femoral nail antirotation (PFNA) and bipolar hemiarthroplasty (BPH) are selected by most of the orthopaedic surgeons for elderly ITFs patients, there is still no consensus on the superiority of PFNA and BPH for ITFs in elderly. In this study, we hypothesized that BPH should not be selected as the primary option for ITFs in elderly patients, and analyzed clinical data of 202 elderly ITFs patients aged 80 years or more treated with PFNA (Group A) and BPH (Group B) to compare the early outcome of PFNA and BPH for ITFs in elderly patients aged 80 years or more. We found that operation time and blood loss during surgery in group A are less than in Group B. Time of weight bearing after operation in Group A is longer than in Group B. Incidence of complications 2 weeks after operation in Group A is 9.29% less than 25.81% in Group B (χ2 = 9.539, p = 0.002). Mortality rates 12 months after operation in Group A is 11.43% similar with 19.35% in Group B (χ2 = 2.261, p = 0.133). Harris Hip Score 12 months after operation in Group A is 68.00 ± 29.11 points similar with 65.73 ± 33.29 points in Group B (t = 0.490, p = 0.625). Therefore, for elderly ITFs patients aged 80 years or more, BPH should not be selected as the primary option for ITFs in elderly patients.