A diaphyseal fitting modular bipolar prosthesis in comminuted trochanteric femur fracturein elderly patient -a prospective study

Abstract

Introduction Intertrochanteric fractures are those occurring in the region extending from the extracapsular basilar neck region to the region along the lesser trochanter. A proximal femur or hip fracture remains the most common reason for an elderly person to be admitted to an acute orthopaedic ward. An estimated 2.1 million hip fractures occurred worldwide in 2021. Assuming there is no age-specific increase, this number is predicted to rise to 2.6 million by 2025 and 4.5 million by 2050. Estimations that include an age-specific increase give predicted values of between 7.3 and 21.3 million by 2050.The total numbers of hip fractures continue to increase as life expectancy continues to increase. The aim of our study was to evaluate the increasing both morbidity and mortality functional outcome of diaphyseal long stem bipolar prothesis in comminuted trochanteric fractures of femur in elderly patients using Harris Hip Score Methodology Patients admitted in Department of Orthopedics in B.L.D.E. (DEEMED TO BE UNIVERSITY) Shri B.M.Patil Medical College, Hospital and Research Centre, Vijayapura with the diagnosis of comminuted trochanteric fracture. The patients will be informed about the study in all respects and informed written consent would be obtained. Patient will be assessed post operatively at 6 weeks, 3 months, 6 months o The period of study will be from MARCH 2023- MARCH 2025.To maintain statistical power, the sample size was increased by 22.5% to allow for a 22.5% dropout rate. Results: This study evaluated 31 elderly patients (mean age: 75.81±9.311 years) with comminuted trochanteric femur fractures treated with a diaphyseal fitting modular bipolar prosthesis. Most patients were aged 61-80 years (71%), with a higher proportion of females (64.5%). Self-falls were the primary injury cause (87.1%). Functional outcomes, assessed using the Harris Hip Score (HHS), showed a mean score of 85.19±4.377, with 64.5% achieving "GOOD," 22.6% "EXCELLENT," and 12.9% "FAIR" outcomes. Complications were minimal: 87.1% had none, 9.7% had leg length discrepancy (LLD), and 3.2% had periprosthetic fracture (PPF). The prosthesis demonstrated favorable results with low complication rates. Conclusion: In conclusion, the use of a diaphyseal fitting modular bipolar prosthesis in elderly patients with comminuted trochanteric femur fractures is associated with good to excellent functional outcomes and a low rate of complications. The results of this study support the use of this surgical method as a viable option for the management of these challenging fractures in elderly patients