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Clinical and Radiological Outcomes of Polished Cemented Bipolar Hemiarthroplasty for Intertrochanteric Fractures in Elderly Patients
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Suc-Hyun Kweon, Chang-Hyun Shin, Yeong-Chang Lee, Min-Woo Kim, Tae-Ho Kim
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J Korean Fract Soc 2020;33(3):134-141. Published online July 31, 2020
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DOI: https://doi.org/10.12671/jkfs.2020.33.3.134
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 Abstract
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- Purpose
To evaluate the clinical and radiological outcomes of bipolar hemiarthroplasty using a polished cemented femoral stem for intertrochanteric fractures in elderly patients.
Materials and Methods
From July 2005 to May 2015, 48 patients diagnosed with intertrochanteric fractures underwent bipolar hemiarthroplasty. The mean age and follow-up period were 80.5 years and 30.5 months, respectively. The postoperative results were evaluated clinically and radiologically.
Results
The mean operation time was 100 minutes (range, 90-120 minutes), and the mean amount of blood loss was 334 ml (range, 170-500 ml). At the last follow-up, the mean Harris hip score (HHS), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 82.2 (range, 76-90), 0.8 (range, 1-3), and 36 (range, 30-40), respectively. Walking was initiated using a walker for partial weight-bearing, and the mean walking time was 5.8 days (range, 3-14 days). Ambulatory ability was restored to a walking state before the injury in 36 cases (75.0%), and wheelchair ambulation was possible in 12 cases (25.0%). The instrumental activities of daily living (IADLs) were 17 patients (35.4%), and the basic activities of daily living (BADLs) were 31 patients (64.6%).
Conclusion
Polished cemented bipolar hemiarthroplasty can achieve secure fixation with no postoperative thigh pain. Restoring the preoperative walking ability will be more helpful for intertrochanteric fractures in elderly patients.
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Teriparatide in fracture healing: biological rationale, clinical evidence, and current limitations
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Won Ro Park, Han Eol Seo, Min-Woo Kim, Young-Min Noh, Ban Seok Kim
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Received August 19, 2026 Accepted September 8, 2026 Published online October 16, 2026
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DOI: https://doi.org/10.12671/jmt.2026.00304
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Abstract
- Teriparatide is an osteoanabolic agent comprising the recombinant human parathyroid hormone (PTH) fragment PTH(1–34) and has attracted interest as a pharmacological adjunct to fracture healing. This narrative review examines its use in acute fractures, delayed union, and nonunion by summarizing the biological rationale, preclinical evidence, clinical findings, and safety considerations. Intermittent administration of teriparatide activates PTH type 1 receptor signaling in osteoblast-lineage cells and osteocytes, promoting osteoblast differentiation and survival, suppressing sclerostin, and enhancing Wnt/β-catenin signaling to support bone matrix formation, mineralization, callus maturation, and remodeling. Preclinical studies, including those using experimental models of impaired fracture healing, have consistently demonstrated enhanced callus formation and mineralization and improved biomechanical recovery. Clinical evidence, however, is less consistent. Recent randomized studies and pooled analyses suggest that teriparatide may shorten the radiographic time to union in some fracture populations, particularly those with osteoporotic hip and pertrochanteric fractures. However, consistent benefits in terms of final union rate, pain, functional recovery, or revision surgery have not been demonstrated. Favorable radiographic and symptomatic outcomes have been reported in delayed union and nonunion, but the evidence comes mainly from case reports, small case series, and uncontrolled observational studies in which surgical or other supportive interventions frequently accompanied teriparatide treatment. Teriparatide should therefore not be regarded as a routine treatment for all fractures or as a replacement for adequate reduction, stable fixation, and infection control. It may have a role as an adjunct in selected clinical contexts involving reduced osteogenic capacity or an increased risk of impaired healing, although the optimal candidate population has not been established. Future prospective comparative studies should standardize patient selection, treatment initiation and duration, and the assessment of clinically relevant structural and functional outcomes.
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