PRIMARY HEMIARTHROPLASTY WITH LEINBACH PROSTHESIS IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC HIP FRACTURES IN ELDERLY PATIENTS
Osman RODOP, Haluk KAPLAN, Ahmet KIRAL, İbrahim AKMAZ, Mesih KUŞKUCU, Ömer ARPACIOĞLU
GATA Haydarpaşa Eğitim Hastanesi Ortopedi ve Travmatoloji Servisi, İstanbul
Keywords: Intertrochanteric Hip Fractures, Leinbach Prosthesis, Primary Hemiarthroplasty.
Introduction: Intertrochanteric fracture of the hip in the elderly is a common orthopedic problem for which many surgical procedures have been prescribed over the years. It’s very important to mobilize the patient as soon as possible postoperatively to prevent systemic complications.
Patients and methods: One hundred and thirty osteoporothic elderly patients with unstable, comminuted intertrochanteric fractures were treated by hemiarthroplasty with Leinbach unipolar prosthesis in our department between 1986 and 1999. The average age was 82.6 years (16 men and 30 women). We evaluated the results of 46 patients who were followed by 5 years, according to Merle d’Aubigné hip rating system.
Results: According to the results of the study, we obtained 8 excellent, 8 good, 12 fair and 18 poor results. There were posterior dislocations in two patients, hematomas in two patients and superficial infections in five patients as early complications. There were deep infections in 2 patients, stem loosening in 7 patients, acetabuler erosions in 7 patients, stem loosening and acetabuler erosion patients and pain at the location of wire cerclaj in 3 patients as late complications. Revisional total hip arthroplasty was applied in 2 patients who had deep infection and in one patient who had protrusio acetabuli.
Discussion: The treatment of intertrochanteric fractures by hemiarthroplasty with unipolar Leinbach prosthesis in elderly patients who had several severe systemic diseases is a good alternative method which allows early activity and prevents complications such as decubitus, pulmoner embolism, deep vein thrombosis and pneumonia.