Hip hemiarthroplasty with bipolar prosthesis by retaining or reconstructing calcar or lesser trochanter:Safe and effective for unstable intertrochanteric fracture in aged patients

Objective Intertrochanteric fracture of the aged patients remains a challenge to orthopedic surgeons in their selection of surgical approaches.This study aimed to evaluate the clinical effect of hip hemiarthroplasty on unstable intertrochanteric fracture in the aged patients.Methods We included in this study 36 patients aged 80 years and over with intertrochanteric fracture combined with displaced femoral calcar and/or lesser trochanter,and treated them by hip hemiarthroplasty with bipolar prosthesis,retaining or reconstructing the calcar or lesser trochanter to rebuild the medial stable structure of the proximal femur.Harris score was used to assess the therapeutic effect.Results X-ray images at the 3rd day revealed no significant differences from those at the 3rd month postoperatively.Based on Harris score,12 cases achieved excellent short-term results,19 good,3 medium and 2 poor.Conclusion Hip hemiarthroplasty with bipolar prosthesis s a safe and effective surgical procedure for unstable intertrochanteric fracture of the aged patients,in which retaining or reconstructiing the calcar or lesser trochanter is critical for the stability of the prosthesis.