Abstract

PESCIALLO, César et al. Prótesis bipolares en pacientes añosos con fractura lateral inestable de cadera. Resultados funcionales y tasa de reoperación luego de los primeros 100 casos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2020, vol.85, n.4, pp.317-324. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2020.85.4.1107.

Introduction: The purpose of this retrospective study was to evaluate the functional outcomes, complications, and reoperations for the treatment of unstable intertrochanteric hip fractures by bipolar hip arthroplasty in elderly patients. Materials and Methods: We analyzed >70-year-old patients with unstable intertrochanteric hip fractures undergoing surgery between 2002 and 2013. Fractures were classified according to the OTA/AO classification. The analysis included length of hospital stay (LOS), Charlson comorbidity index (CCI), time to weight-bearing, need for weight-bearing assistance, all complications related to the procedure, and the reoperations rate. Results: Study population consisted of 100 patients (84 females, 16 males), with 101 fractures. Average age was 82.4 years (range, 72-102 years). Fractures were categorized as A2.2 in 59 cases and A2.3 in 42 cases. The average CCI was 6.23 (range, 4-9). The average LOS was 6.95 days (range, 5-18). Weight-bearing ambulation started on postoperative day 2 in 87.12% of cases. The average Harris hip score (HHS) was 84.7 (range, 69-92). The average follow-up period was 28.4 months (range, 12-40). There were 7 (6.93%) complications: 2 (1.98%) deep venous thrombosis, 1 (0.99%) pulmonary thromboembolism, 3 (2.97%) periprosthetic infections and 1 (0.99%) dislocation. The reoperation rate was 2.97%. Complications were significantly related to age (P=0.005) and to ICC (odds ratio [OR]: 2.8071; 95% confidence interval [CI]: 1.4105-5.58669). Conclusions: Bipolar prostheses allowed for early rehabilitation with acceptable functional outcomes, associated with a low complication rate (6.93%) and a low reoperation rate (2.97%).

Keywords : Elderly patients; intertrochanteric hip fracture; bipolar prosthesis; hemiarthroplasty; functional outcomes; reoperation.

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