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Original Article
Mortality-Related Risk Factors in Total Hip Arthroplasty for Femoral Neck Fractures in Elderly Patients
Jae Sung Suh, Hyung Gon Ryu, Young Ju Roh, Dae Won Shin
J Korean Fract Soc 2022;35(2):51-56.   Published online April 30, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.2.51
AbstractAbstract PDF
Purpose
Total hip arthroplasty (THA) using dual mobility components (DMC) is a reasonable surgical option for displaced femoral neck fractures in elderly patients, resulting in lower dislocation rates and improved stability. The purpose of this study was to investigate the clinical outcomes and risk factors responsible for mortality in elderly patients who were diagnosed with a displaced femoral neck fracture and had undergone DMC-THA.
Materials and Methods
Out of 147 cases of THA from December 2018 to June 2020, a total of 79 cases were enrolled in this study, with the following characteristics: (1) Garden stage III or IV, (2) over 75 years of age, and (3) over 1 year of follow-up. All the patients received DMC-THA surgery using the anterolateral approach.
Results
The mean follow-up period was 15.0±8.43 months and a total of one dislocation case was observed. The mortality rate was 17.7% (14/79), and it was especially higher in patients with a past medical history of malignancy (odds ratio [OR]=7.18, p=0.03) or a cognitive disorder such as dementia (OR=5.48, p=0.03). Preoperative low initial hemoglobin levels (OR=0.65, p=0.04) and low UCLA (Uni-versity of California at Los Angeles) score (OR=0.47, p=0.02) were also associated with mortality.
Conclusion
When considering THA as a treatment approach in elderly patients with a displaced femoral neck fracture, a high mortality rate is expected in patients with low preoperative hemoglobin levels or a history of malignancy or cognitive disorders. Hence, thorough monitoring and management should be undertaken before and after surgery.

Citations

Citations to this article as recorded by  
  • Comparison of Operation Time, Vital Signs, Bleeding Tendency, and Recovery Time Based on Anesthesia Methods in Patients Undergoing Hip Fracture Surgery
    Je Bog Yoo, Woo Young In, Chang Ok Pyo, Jeung Hee Kwon, Min Ji Lee, Kwang Hee Kim, Kyoung Ok Kim, Mi Yu
    Journal of PeriAnesthesia Nursing.2025;[Epub]     CrossRef
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Case Report
Recurrent Treatment Failure in Vancouver Classification Type C Periprosthetic Fractures around a Well Fixed Short Femoral Stem
Byeong Yeol Choi, Hong-Man Cho, Jiyeon Park
J Korean Fract Soc 2022;35(1):16-20.   Published online January 31, 2022
DOI: https://doi.org/10.12671/jkfs.2022.35.1.16
AbstractAbstract PDF
A short femoral stem (type 1 cementless stem) is being increasingly used to perform total hip arthroplasty; however, various types of intra- or postoperative periprosthetic fractures have been reported in recent times. A 66-year-old woman with a history of bilateral total hip arthroplasties using a type 1B femoral stem was admitted 2 months post-operation for a Vancouver type C periprosthetic fracture. She underwent open reduction and internal fixation; however, we observed recurrent non-union and plate breakage at the same site. In this case report, we discuss the factors associated with treatment failure in patients with a Vancouver type C periprosthetic fracture following type 1 femoral stem im-plantation.
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Original Article
Clinical and Radiological Outcomes of Polished Cemented Bipolar Hemiarthroplasty for Intertrochanteric Fractures in Elderly Patients
Suc-Hyun Kweon, Chang-Hyun Shin, Yeong-Chang Lee, Min-Woo Kim, Tae-Ho Kim
J Korean Fract Soc 2020;33(3):134-141.   Published online July 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.3.134
AbstractAbstract PDF
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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Review Articles
Periprosthetic Fracture after Total Shoulder Arthroplasty
Nam Su Cho, Myung Seo Kim, Jae Woo Yang, Jeung Hwan Seo, Dong Won Seo
J Korean Fract Soc 2020;33(2):118-123.   Published online April 30, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.2.118
AbstractAbstract PDF
Periprosthetic humeral fractures in patients with total shoulder arthroplasty are rare and difficult to treat. With the significant increase in the number of older patients who have undergone total shoulder arthroplasty in recent years, an increase in the number of periprosthetic shoulder fractures can be estimated. The decisions of treatment have to be taken individually, depending on the stability of the prosthesis, fracture location, and bone quality. On the other hand, there are limited data for treatment guidance and outcomes. This paper reviews the risk factors, classification, treatment, and outcomes of periprosthetic humeral fractures.
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Treatment of Periprosthetic Fracture after Total Elbow Replacement Arthroplasty
Hyunseok Seo, Jin-Hyung Im, Joo-Yup Lee
J Korean Fract Soc 2020;33(2):110-117.   Published online April 30, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.2.110
AbstractAbstract PDF
The indications for total elbow replacement arthroplasty (TERA) include rheumatoid arthritis, degenerative arthritis, acute fracture, nonunion, malunion, posttraumatic arthritis, tumor, and chronic instability. With the development of designs and the increasing use of TERA, more periprosthetic fractures are occurring. On the other hand, there is less data on periprosthetic fractures after TERA because TERA is a relatively rare procedure. Thus, a careful review of the previous literature and appropriate selection of surgical indications are essential for achieving a satisfactory outcome, which should be accompanied by precise surgery as planned. This article presents the causes, risk factors, classification, and principles of treatment of periprosthetic fractures after TERA.

Citations

Citations to this article as recorded by  
  • Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty
    Young-Hoon Jo, Seung Gun Lee, Incheol Kook, Bong Gun Lee
    Clinics in Shoulder and Elbow.2020; 23(3): 152.     CrossRef
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Periprosthetic Fractures following Total Knee Arthroplasty
Byung Hoon Lee, Jae Ang Sim
J Korean Fract Soc 2020;33(1):52-61.   Published online January 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.1.52
AbstractAbstract PDF
Recently, as the elderly population increases, the incidence of total knee arthroplasty has increased, with a concomitant increase in the frequency of periprosthetic fractures. To determine the treatment plan for fractures, the treatment method should be determined by the patient's age, osteoporosis, fixation status of the implant, and type of fracture. In recent years, operative treatment with reduction and stable fixation, rather than non-operative treatment, was used to promote early joint movement and gait. On the other hand, it is necessary to select an appropriate operative method to reduce complications of surgery, such as nonunion and infection, and expect a good prognosis. In this review, periprosthetic fractures were divided into femur, tibia, and patella fractures, and their causes, risk factors, classification, and treatment are discussed.
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Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty
Jung Hoon Choi, Jong Hyuk Jeon, Kyung Jae Lee
J Korean Fract Soc 2020;33(1):43-51.   Published online January 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.1.43
AbstractAbstract PDF
Although the incidence of postoperative periprosthetic femoral fractures after hip arthroplasty is expected to increase, these complex fractures are still challenging complications. To obtain optimal results for these fractures, thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are mandatory. The Vancouver classification system is a simple, effective, and reproducible method for planning proper treatments of these injuries. The fractures associated with a stable femoral stem can be effectively treated with osteosynthesis, though periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. We describe here the principles of proper treatment for the patients with periprosthetic femoral fractures as well as how to avoid complications.
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Total Hip Arthroplasty after Acetabular Fracture: Acute Phase and Delayed Phase
Hwan Hee Lee, Se Won Lee, Weon Yoo Kim
J Korean Fract Soc 2019;32(4):232-239.   Published online October 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.4.232
AbstractAbstract PDF
The incidence of acetabular fractures in the elderly has increased because of the increasing elderly population. To determine the treatment plan for acetabular fractures, the patient's age, gait ability, presence or absence of osteoporosis and osteoarthritis, underlying disease, and fracture pattern should be considered. The application of total hip arthroplasty for acetabular fractures with the proper indications can be expected to have a good prognosis. In this paper, the application of total hip arthroplasty as a treatment method for acetabular fractures is divided into acute and delayed phases.

Citations

Citations to this article as recorded by  
  • Effect of Korean Medicine Treatments for Pain Reduction in Patients with Hip Fracture : A Retrospective Observational Study
    Nam Hoon Kim, Min Seok Oh
    Journal of Physiology & Pathology in Korean Medicine.2020; 34(5): 263.     CrossRef
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Principles for Management of Periprosthetic Acetabular Fractures after Hip Arthroplasty
Chan Woo Park, Hyoung Keun Oh, Woo Suk Lee, Youn Soo Park, Seung Jae Lim
J Korean Fract Soc 2019;32(3):148-156.   Published online July 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.3.148
AbstractAbstract PDF
Periprosthetic acetabular fracture (PAF) is an uncommon complication following hip arthroplasty. However, as the number of people needing hip prostheses continues to rise, the absolute number of PAF is expected to increase as well. These fractures may occur either intraoperatively or postoperatively. Postoperative fractures can be caused by traumatic events or by pathologic conditions related to periacetabular osteolysis. The management of PAF usually depends on the degree of displacement and the stability of the acetabular component. While most of non-displaced fractures can be managed nonoperatively by protected weight bearing, displaced fractures with unstable implants require surgical intervention, which is often technically challenging. This review summarized the latest findings on the epidemiology, the diagnosis, the classification, and the treatment of PAF.

Citations

Citations to this article as recorded by  
  • Treatment of Periprosthetic Femoral Fractures after Hip Arthroplasty
    Jung-Hoon Choi, Jong-Hyuk Jeon, Kyung-Jae Lee
    Journal of the Korean Fracture Society.2020; 33(1): 43.     CrossRef
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Case Reports
Cortical Perforation Misidentified with Medial Condylar Fracture of Femur in Total Knee Arthroplasty: Case Report
Seung Suk Seo, Sang Won Moon
J Korean Fract Soc 2019;32(1):52-55.   Published online January 31, 2019
DOI: https://doi.org/10.12671/jkfs.2019.32.1.52
AbstractAbstract PDF
Intraoperative fracture in total knee arthroplasty (TKA) is a rare complication. However, when it happens, additional surgery to fix the fracture site is needed. Therefore, it is important to diagnose intraoperative fractures in TKA exactly. The authors experienced two cases of cortical perforation of medial femoral condyle misidentified as the fracture in TKA. Cortical perforation could be misdiagnosed as the fracture, which could lead to unnecessary surgery. This is the first report about cortical perforation in TKA. We report two cases of intraoperative cortical perforations and describe the radiological characteristics.
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Iatrogenic Humeral Fracture during Reduction of Shoulder Dislocation: Two Cases Report
Hyung Lae Cho, Hyoung Min Kim, Ki Bong Park, Tae Hyun Wang, Dong Hyun Lee
J Korean Fract Soc 2016;29(1):50-54.   Published online January 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.1.50
AbstractAbstract PDF
Shoulder dislocation is the most common dislocation presenting to the emergency department. In old age, the attempt of closed reduction is made with caution in order to prevent iatrogenic fracture around the shoulder. We report two cases of iatrogenic fractures of humeral shaft and anatomical neck in female patients older than 70 years old, which occurred during the manual closed reduction. One patient was proved as first-time and the other was recurrent. In addition, the second case had a massive irreparable rotator cuff tear. Those patients were treated successfully with humeral nailing and reverse total shoulder arthroplasty, respectively.
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Original Articles
The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures
Bo Ram Na, Taek Rim Yoon, Kyung Soon Park
J Korean Fract Soc 2016;29(1):26-33.   Published online January 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.1.26
AbstractAbstract PDF
PURPOSE
The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF).
MATERIALS AND METHODS
Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared.
RESULTS
The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3degrees (105degrees-140degrees) in the DCP group and 118.4degrees (110degrees-140degrees) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups.
CONCLUSION
A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.
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The Short Term Results of Radial Head Arthroplasty with Unipolar Loose Fit Stem
Su Keon Lee, Kyeong Seop Song, Seung Hwan Lee, Sang Pil Yoon, Sang Youn Lim
J Korean Fract Soc 2015;28(2):125-131.   Published online April 30, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.2.125
AbstractAbstract PDF
PURPOSE
We report short-term results of radial head prosthesis using a unipolar loose fit stem in ten patients.
MATERIALS AND METHODS
Ten patients with Mason type three radial head fracture, who received unipolar radial head arthroplasty from February 2010 to June 2011, were evaluated (mean follow-up: 22 months, range: 18-30 months). Subjects consisted of five men and five women. Range of elbow motion was measured. Mayo elbow performance index (MEPI) score was used for functional evaluation and periodic radiological imaging was performed to evaluate the stability of implant.
RESULTS
After an average follow-up of 22 months, elbow stability was maintained in all cases, and the average range of motion of elbow flexion and extension was 6 to 130 degrees. Average range of pronation and supination was 66 and 74 degrees, respectively. MEPI score was evaluated as excellent in seven cases, and good in three cases. On final follow-up, radiological assessment showed implant stability in all cases without evidence of dislocation, subluxation, arthritis, periprosthetic osteolysis or heterotopic ossification.
CONCLUSION
Based on our short-term follow-up, radial head arthroplasty with unipolar loose fit stem is a useful method for obtaining satisfactory outcome for unreducible comminuted radial head fractures.
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Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture
Doo Sup Kim, Dong Kyu Lee, Chang Ho Yi, Jang Hee Park, Jung Ho Rah
J Korean Fract Soc 2011;24(2):144-150.   Published online April 30, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.2.144
AbstractAbstract PDF
PURPOSE
Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures.
MATERIALS AND METHODS
Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically.
RESULTS
On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75+/-6.5 points and 70+/-7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78+/-5.4 points from the former and 71+/-2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72+/-8 points for the internal fixation group and 69+/-9.2 points for the hemiarthroplasty group (p=0.041).
CONCLUSION
Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.

Citations

Citations to this article as recorded by  
  • Surgical treatment of proximal humerus fractures: a systematic review and meta-analysis
    Erik Hohmann, Natalie Keough, Vaida Glatt, Kevin Tetsworth
    European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2215.     CrossRef
  • Effectiveness and Safety of Interventions for Treating Adults with Displaced Proximal Humeral Fracture: A Network Meta-Analysis and Systematic Review
    Long Chen, Fei Xing, Zhou Xiang, Ara Nazarian
    PLOS ONE.2016; 11(11): e0166801.     CrossRef
  • Meta-analysis comparing locking plate fixation with hemiarthroplasty for complex proximal humeral fractures
    Jiezhi Dai, Yimin Chai, Chunyang Wang, Gen Wen
    European Journal of Orthopaedic Surgery & Traumatology.2014; 24(3): 305.     CrossRef
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Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis: Comparative Analysis between Cementless Stem and Cemented Stem
Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi
J Korean Fract Soc 2011;24(1):16-22.   Published online January 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.1.16
AbstractAbstract PDF
PURPOSE
We evaluated the usefulness of the cementless stem in treating hip fracture patients older than 70.
MATERIALS AND METHODS
We studied elderly osteoporotic hip fractures in the neck and intertrochanter area who had received hip arthroplasty with over 2 years of follow up period. Among those, we analyzed the clinical and radiological results of hip arthroplasty with cemented stem (group 1) and hip arthroplasty with cementless stem (group 2). Each group was consists of fifty hips.
RESULTS
The mean age at surgery was 75 years and mean follow-up period was 40 months (minimum 24 months). The admission period was 28.68+/-8.8 days for group 1 and 28.05+/-8.7 days for group 2 (p>0.05) and the average operation time was 87+/-21.2 minutes, and 80+/-17 minutes (p>0.05) and the total blood loss was 611+/-141.3 cc and 557+/-120.5 cc (p>0.05) respectively. There was no statistically significant difference in all aspects. One case of pulmonary embolism occurred in group 1. Stem loosening was not observed in both groups at the last follow-up radiologic study.
CONCLUSION
The hip arthroplasty with cementless stem for the osteoporotic hip fractures showed a competent results clinically and radiologically in short term follow up as compared with the cemented stem.
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Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients
Han Jun Lee, Jong Won Kim, Jae Sung Lee, Jae June Yang, Woo Young Hwang
J Korean Fract Soc 2010;23(3):276-281.   Published online July 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.3.276
AbstractAbstract PDF
PURPOSE
To evaluate clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.
MATERIALS AND METHODS
From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.
RESULTS
The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.
CONCLUSION
In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.

Citations

Citations to this article as recorded by  
  • The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
    Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
    Hip & Pelvis.2014; 26(2): 99.     CrossRef
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Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly
Duk Hwan Kho, Ki Hwan Kim, Hyeung Jun Kim, Dong Heon Kim
J Korean Fract Soc 2009;22(4):239-245.   Published online October 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.4.239
AbstractAbstract PDF
PURPOSE
To evaluate the results of the treatment of femoral basicervical fractures aged 75 years or older. MATERIALS AND METHODS: We reviewed the clinical records of 60 patients who were older than 75 years and who underwent bipolar hemiarthroplasty for femoral basicervical fractures using calcar replacement stem between March 1999 and November 2005. The minimum follow up period was 2 years. We analyzed the results by conducting radiological and clinical evaluations such as assessing the patient's walking ability and modified Harris hip score, the activities of daily living, the associated medical conditions and arthritis, and postoperative disgnosis. RESULTS: The mean Harris hip score were 87.2 (74~92). Walking ability was recovered in 91% (55 cases) and activity of daily living was achived in 91% (55 cases). Press-fit fixations were 56 cases and bony ingrowth fixations were 57 cases. Stress shields were 28% (17 cases). Thigh pains were 5% (3 cases) and revision rate was 3% (2/60 cases). CONCLUSION: We consider bipolar hemiarthroplasty using calcar replacement stem in femoral basicervical fractures in the Elderly with severe osteoporosis is the useful treatment in view of the stable and rigid fixation of femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.
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Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
Jin Wan Kim, Young Chul Ko, Chul Young Jung, Il Soo Eun, Hyeon Soo Choi, Ok Gul Kim, Young June Kim
J Korean Fract Soc 2009;22(4):232-238.   Published online October 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.4.232
AbstractAbstract PDF
PURPOSE
To evaluate the clinical and radiological outcome of the greater trochanter reattachment device (GTRD) as firm fixation method for displaced greater trochanter fragment in bipolar hemiarthroplasty for comminuted intertrochanteric femur fracture in elderly patients. MATERIALS AND METHODS: From January 2006 to January 2008, 32 patients above 70 years old treated with bipolar hemiarthroplasty using the GTRD as fixation method for comminuted intertrochanteric femur fracture with greater trochanter bone fragment displaced above 1 cm. They were followed up for more than one year. Clinically, the postoperative Harris hip score (HHS) and daily activities of life of Johnston et al were evaluated, and radiological, any displacement of greater trocharter bone fragments and/or GTRD. RESULTS: The mean postoperative HHS was 71.6 (range, 53~82) points. In rating the daily activity of life, twenty seven (84.4%) patients` postoperative results were above fair. Two patients (6.3%) had displacement of the greater trochanter bone fragment above 1 cm. One patient had a deep infection, so we removed the bipolar head and inserted antibiotics-loaded cement block instead, and after the infection was controlled, conversion to total hip arthroplasty was done. CONCLUSION: In bipolar hemiarthroplasty for comminuted intertrochanteric femur fracture with displaced greater trochanter bone fragment, GTRD produced satisfactory results and early rehabilitation.
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Treatment of Unstable Intertrochanteric Fracture in Elderly Patients : Comparison between the Results of Internal Fixation Using Compression Hip Screw and Cemented Bipolar Hemiarthroplasty
Myung Sik Park, Woo Chul Jung, Hyuk Park, Byung Yun Hwang, Young Jin Lim, Myung Guk Jung, Hong Man Cho
J Korean Fract Soc 2009;22(3):138-144.   Published online July 31, 2009
DOI: https://doi.org/10.12671/jkfs.2009.22.3.138
AbstractAbstract PDF
PURPOSE
To perform comparative analysis between the results of internal fixation using compression hip screw and cemented bipolar hemiarthroplasty in unstable intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
From January 2001 to October 2006, we reviewd 73 patients, who were treated surgically for unstable intertrochanteric fractures, with a minimum of 2 years follow up. The patient's age was older than 60 year old. The patients were divided into two groups and evaluated, retrospectively. One group was treated with cemented bipolar hemiarthroplasty (Group A, 34 cases), and the other group was treated with compression hip screw (Group B, 39 cases). We evaluated the amount of intraoperative bleeding, operative time, clinical results and complications between the two groups.
RESULTS
The amount of intraoperative bleeding and operative time were no statistically significant between the two groups. Group A showed a better result than Group B for clinical outcome using Johnson Daily Activity of Life. Complications in the group A were comprised of dislocation (1 case), nonunion of greater trochanter (1 case), infection (1 case) and loosening (1 case), and those in the group B were comprised of loss of fixation (8 cases) and infection (1 case).
CONCLUSION
We found that short-term outcomes of cemented bipolar hemiarthroplasty for unstable intertrochanteric fractures were satisfactory. However, a longer-follow up period is necessary to clarify the efficacy of cemented bipolar hemiarthroplasty.

Citations

Citations to this article as recorded by  
  • Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis
    Jun-Il Yoo, Yong-Chan Ha, Jae-young Lim, Hyun Kang, Byung-Ho Yoon, Hyunho Kim
    Journal of Korean Medical Science.2017; 32(5): 858.     CrossRef
  • The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
    Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
    Hip & Pelvis.2014; 26(2): 99.     CrossRef
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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly
Duk Hwan Kho, Ki Hwan Kim, Hyeung June Kim, Dong Heon Kim
J Korean Fract Soc 2008;21(3):232-239.   Published online July 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.3.232
AbstractAbstract PDF
PURPOSE
To evaluate the results of bipolar hemiarthroplasty using calcar replacement stem for hip fractures in elderly patients.
MATERIALS AND METHODS
Between March 1995 and March 2005, the clinical records on 68 cases more than 75 years old who underwent the bipolar hemiarthroplasty using calcar replacement stem and followed minimum 2 years were reviewed. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, complications, osteoporosis and radiologic findings.
RESULTS
The mean postoperative modified Harris hip score was 88.3 (69~95) in femoral neck fractures and 83.5 (63~91) in femoral intertrochanteric fractures. Walking ability was recovered in 82.3% (56 cases) and activity of daily living was achived in 82.3% (56 cases). Complications were thigh pain, infection, femoral stem subsidence, stress shield, dislocation.
CONCLUSION
We consider bipolar hemiarthroplasty using calcar replacement stem for unstable hip fractures in elderly patients with severe osteoporosis is the useful treatment in view of the stable and rigid fixation, early ambulation and the low rate of complications, even if the operation is technically very difficult.

Citations

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  • Bipolar Hemiarthroplasty With a Calcar Stem for the Management of a Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Case of Geriatric Unstable Intertrochanteric Femur Fracture
    Mukesh O Phalak, Tushar Chaudhari, Ajinkya K Chaudhari
    Cureus.2024;[Epub]     CrossRef
  • Bipolar Hemarthroplasty Using Cementless Conical Stem for Treatment of Dorr Type B and C Femoral Neck Fracture
    Jeong Hoon Kang, Sang Hong Lee, Sung Jung
    Hip & Pelvis.2015; 27(4): 232.     CrossRef
  • Assessment of the Clinical Features of Bilateral Sequential Hip Fractures in the Elderly
    Duk-Hwan Kho, Ju-Yong Shin, Hyeung-June Kim, Dong-Heon Kim
    The Journal of the Korean Orthopaedic Association.2009; 44(3): 369.     CrossRef
  • Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly
    Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-Jun Kim, Dong-Heon Kim
    Journal of the Korean Fracture Society.2009; 22(4): 239.     CrossRef
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Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures
Chung Hee Oh, Joo Han Oh, Sae Hoon Kim, Ki Hyun Jo, Sung Woo Bin, Hyun Sik Gong
J Korean Fract Soc 2008;21(3):213-219.   Published online July 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.3.213
AbstractAbstract PDF
PURPOSE
To evaluate the outcome of hemiarthroplasty with bone block graft and low profile prosthesis (Aequalis(R) fracture prosthesis) for the comminuted proximal humerus fractures.
MATERIALS AND METHODS
Sixteen low profile prostheses were used since July 2004, and 11 patients were followed-up for average 19.9 (12~30) months. Their mean age was 67.3 (52~78) years. Pain and satisfaction visual analog scale (VAS), range of motion, and modified UCLA score for hemiarthroplasty were evaluated at every visit. Radiography was also checked for stem position, loosening, and tuberosity union.
RESULTS
Mean pain VAS was 2.7 (0~5), and mean satisfaction VAS was 8.4 (5~10). Mean active forward flexion was 137 degrees (90~170), external rotation at side was 45.5 degrees (25~70), and internal rotation at back was T10 (T7~L1). Modified UCLA score was 19 (12~30) at final visit. All stems were stable, and there were no loosening at the final follow-up. All tuberosities were united except two tuberosity absorptions.
CONCLUSION
The outcome of hemiarthroplasty with bone block graft and low profile prosthesis was comparable to other implants for comminuted proximal humerus fractures. This system had unique advantages for tuberosity union. Further study with more patients and longer follow-up are necessary to clarify the effectiveness of this prosthesis.

Citations

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  • A Separate Approach and Cephalo-Diaphyseal Plate Fixation for the Comminuted Metadiaphyseal Fractures of the Proximal Humerus
    Sung-Weon Jung
    Journal of the Korean Fracture Society.2013; 26(1): 8.     CrossRef
  • Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture
    Doo-Sup Kim, Dong-Kyu Lee, Chang-Ho Yi, Jang-Hee Park, Jung-Ho Rah
    Journal of the Korean Fracture Society.2011; 24(2): 144.     CrossRef
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Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
Woong Kyo Jeong, Sang Won Park, Soon Hyuck Lee, Jong Hoon Park, Suk Ha Lee, Ji Hoon Kang, Gi Won Choi, Won Noh
J Korean Fract Soc 2008;21(1):8-12.   Published online January 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.1.8
AbstractAbstract PDF
PURPOSE
To evaluate the clinical results of bipolar hemiarthroplasty in elderly patients more than 65 years of age with a femoral neck fracture.
MATERIALS AND METHODS
Forty-six bipolar hemiarthroplasties in 43 patients more than 65 years of age which could be followed more than 3 years were included in this study. The clinical outcomes were evaluated using Harris hip score, pain score and support score. The radiological results were analyzed by femoral stem loosening and bipolar cup migration.
RESULTS
The average Harris hip score was 88.7 (62~96) points. An excellent score was recorded in 34 cases, good in 7 cases, fair in 3 cases and poor in 2 cases. The average pain score was 39.3 points and there were no pain in 20 cases, slight pain in 17 cases, mild pain in 6 cases and moderate pain in 2 cases. The average support score was 9.6 points and 32 patients could walk without the use of any assistive devices. Two cases were converted to total hip arthroplasty due to femoral stem loosening with or without bipolar cup migration.
CONCLUSION
For the early ambulation and functional recovery of elderly patients with femoral neck fracture, bipolar hemiarthroplasty was considered as one of recommendable methods.
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Midterm Results of Treatment with a Retrograde Nail for Periprosthetic Fractures of the Femur Following Total Knee Arthroplasty
Kyung Taek Kim, Jin Hun Kang, Lih Wang, Jae Sung Hwang
J Korean Fract Soc 2007;20(4):309-314.   Published online October 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.4.309
AbstractAbstract PDF
PURPOSE
To analyze the midterm results of the treatment with a retrograde nail for periprosthetic fractures of the femur following total knee arthroplasty.
MATERIALS AND METHODS
Between Jan 1998 and Jan 2004, 11 cases in 11 patients were treated for the periprosthetic fractures following total knee arthroplasty. The mean follow-up was 42.0 (30~98) months and the mean age was 66.0 (57~79) years old. 2 were males and 9 patients were females. In all cases, retrograde nailing was done for the periprosthetic fractures. Postoperative range of motion, HSS knee rating score, femorotibial angle, the time required for union, complications were evaluated.
RESULTS
Postoperative range of motion was 103.6° degrees on an average, HSS knee rating score was 83.5 points on an average at the last follow up. The mean angulation on radiograph was valgus 6.3°. The mean time required for union was 4 months. One had a newly fracture line at proximal part of supracondylar fracture, but there was no significant in clinical course. There was no prostheses required revision.
CONCLUSION
It appears that retrograde nail is a reliable surgical technique for periprosthetic fractures of the femur following total knee arthroplasty with low complication rate. The midterm results in our study showed that none of the prostheses required revision.
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Comparison between Results of Internal Fixation and Hemiarthroplasty in Unstable Intertrochanter Fracture of Osteoporotic Bone
Haw Jae Jung, Jae Yeol Choi, Hun Kyu Shin, Eugene Kim, Se Jin Park, Yong Taek Lee, Gwang Sin Kim, Jong Min Kim
J Korean Fract Soc 2007;20(4):291-296.   Published online October 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.4.291
AbstractAbstract PDF
PURPOSE
To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone.
MATERIALS AND METHODS
From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically.
RESULTS
Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered.
CONCLUSION
Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.

Citations

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  • The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization
    Sung-Rak Lee, Seong-Tae Kim, Min Geun Yoon, Myung-Sang Moon, Jee-Hyun Heo
    Clinics in Orthopedic Surgery.2013; 5(1): 10.     CrossRef
  • Analysis of the Factors Involved in Failed Fixation in Elderly Intertrochanteric Femoral Fracture
    Joon Soon Kang, Ryuh Sup Kim, Bom Soo Kim, Young Tae Kim, Seung Hyun Hong
    Journal of the Korean Fracture Society.2012; 25(4): 263.     CrossRef
  • Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip
    Soo Jae Yim, Young Koo Lee, Cheong Kwan Kim, Hyun Seok Song, Hee Kyung Kang
    Journal of the Korean Fracture Society.2010; 23(2): 167.     CrossRef
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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients
Duk Hwan Kho, Ju Yong Shin, Ki Hwan Kim, Jun Hyuck Lee, Dong Heon Kim
J Korean Fract Soc 2007;20(2):129-134.   Published online April 30, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.2.129
AbstractAbstract PDF
PURPOSE
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
MATERIALS AND METHODS
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
RESULTS
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
CONCLUSION
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.

Citations

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  • Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
    Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
    Injury.2017; 48: S72.     CrossRef
  • Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
    Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
    Hip & Pelvis.2013; 25(4): 274.     CrossRef
  • Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
    Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
    Journal of the Korean Fracture Society.2009; 22(4): 232.     CrossRef
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Comparative Study of Bipolar Hemiarthroplasty and Second Generation Intramedullary Nailing on Treatment of Elderly Unstable Peritrochanteric Femoral Fractures
Ho Hyun Yun, Gil Yeong Ahn, Il Hyun Nam, Gi Hyuk Moon, Jae Wook Lee, Jae Cheol Kim
J Korean Fract Soc 2006;19(2):128-134.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.128
AbstractAbstract
PURPOSE
To evaluate and compare the clinical and radiological outcome of bipolar hemiarthroplasty and second generation intramedullary nailing for elderly unstable peritrochanteric femoral fracutre.
MATERIALS AND METHODS
From January 2000 to July 2004, 56 elderly unstable peritrochanteric fractures were treated with a bipolar hemiarthroplasty (34 cases) or a ITST intramedullary nailing (22 cases). The fractures were classified using the OTA/AO classification. The clinical results were evaluated by walking capability, hip joint pain, and thigh pain. The radiological results were evaluated on the basis of the radiographs at follow-up.
RESULTS
In bipolar hemiarthroplasty group, The mean operation time was 134 minute, the mean blood loss was 648 ml. In intramedullary nailing group, The mean operation time was 103 minute, the mean blood loss was 386 ml. There were no different walking ability between prefracture and postoperative state in 22 cases (65%) of bipolar hemiarthroplasty group, 18 cases (80%) of intramedullary nailing group respectively. There were 5 cases (14%) hip joint pain in bipolar hemiarthroplasty group and 4 cases (18%) thigh pain in ITST intramedullary nailing group postoperatively.
CONCLUSION
Comparing the operation time, blood loss, and walking ability, ITST intramedullary nailing group show superior clinical outcomes than bipolar hemiarthroplasty group. However, The effort for decreasing postoperative thigh pain might be required.
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Bipolar Hemiarthroplasty of Displaced Femoral Neck Fractures in Pakinsonism Patients
Hyung Ku Yoon, Byung Kuk Kim, Dong Eun Shin, Sang Jun Song, Hyung Kun Park, Ji Hoon Chang
J Korean Fract Soc 2005;18(2):126-130.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.126
AbstractAbstract PDF
PURPOSE
To evaluate clinical outcome and functional result after cemented bipolar hemiarthroplasty of displaced neck fracture in parkinsonism patients.
MATERIALS AND METHODS
12 parkinsonism patients treated by cemented bipolar hemiarthroplasty of displaced femur neck fracture from August 1994 to October 2002 were evaluated. Posterolateral approach was performed. Preoperative and postoperative walking ability, activity of daily life and severity of parkinsonism were compared. The effects of parkinsonism on clinical outcome were analyzed retrospectively.
RESULTS
The median difference of walking ability was 1 (p=0.001) and that of ADL scale was -3 (p=0.0005). There was no significant change in the severity of parkinsonism (p=0.5), and the severity and duration of parkinsonism were not correlated with postoperative functional status. 7 cases of voiding difficulty, 5 of temporary delirium, and 2 of temporary respiratory insufficiency were noted as general complications. 2 cases of dislocation and 1 of infection were noted as orthopaedic complications.
CONCLUSION
In parkinsonism patient, walking ability was worsened, activity was more independent, but severity of parkinsonism was not changed after hemiarthroplasty of displaced femur neck fracture. Orthopaedic surgeons should bear in mind that functional outcome is poor and orthopaedic complication rate high in parkinsonism.

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  • Failure of Long Spinal Construct and Pseudarthrosis in a Patient with Parkinson Disease for the Treatment of Degenerative Lumbar Spinal Disorder: Case Report
    Hong Kyun Kim, Hyun Woo Na, Kook Jin Chung
    Journal of Korean Society of Spine Surgery.2014; 21(4): 174.     CrossRef
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Treatment of Failed Internal Fixation of Intertrochanteric Fractures of Femur
Hyung Gyu Kim, Byeong Mun Park, Kyeong Seop Song, Chang Hun Sung, Jong Min Kim, Jae Hyung Cho, Nam Heun Kim
J Korean Fract Soc 2005;18(2):120-125.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.120
AbstractAbstract PDF
PURPOSE
To compare the result of failed internal fixation of intertrochanteric fractures treated with arthroplasty and 95degrees angled blade plate.
MATERIALS AND METHODS
From June 2000 to may 2003, there were 12 cases with failed internal fixation of intertrochanteric fractures among 185 cases treated with dynamic hip screw and followed up for more than 1 year. The 4 cases were treated with bipolar hemiarthroplasty, 1 case with total hip arthroplasty, and other 7 cases were treated with 95degrees angled blade plate with allograft, evaluated clinically the operation times, blood loss, walking ability and complication.
RESULTS
In the 7 cases, which treated with 95degrees angled blade plate, the average operation time was 109 minutes, the average blood loss was 431 ml. The result of keeping abreast of 1 year, no aid ambulation was 4 cases, the cane ambulation was 2 cases, the walker ambulation was 1 case, and there was no pain in 3 cases, mild pain in 4 cases, and no moderate pain. In the 5 cases, which treated with arthroplasty, the average operation time was 157 minutes, the average blood loss was 618 ml. During 1 year, no aid ambulation was 3 cases, the cane ambulation was 1 case, the walker ambulation was 1 case, and no pain in 2 cases, mild pain in 1 case, moderate pain in 1 case.
CONCLUSION
Both 95degrees angled blade plate and arthroplasty can be useful for failed internal fixation of intertrochanteric fractures, and the choice of implant must be determined with caution, considering the surgical conditions of patient, as well as benefits of each devices
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Comparison of Clinical Results between Bipolar Hemiarthroplasty and Compression Hip Screw on Unstable Intertrochanteric Fractures of the Femur in Elderly Patients
Eui seoung Yoon, Hak Jin Min, Jae Seong Suh, Yoon Jong Kim, Hee Seon Kim, Yong Jun Lee, Jeong Min Heo
J Korean Fract Soc 2004;17(3):214-220.   Published online July 31, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.3.214
AbstractAbstract PDF
PURPOSE
To investigate postoperative incidence of complications and functional results between two groups, primary bipolar hemiarthroplasty and internal fixation with compression hip screw on unstable intertrochanteric fractures of the femur with severe osteoporosis in elderly patients.
MATERIALS AND METHODS
78 cases treated under unstable intertrochanteric fractures of the femur with severe osteoporotic elderly patients from March 1997 to August 2001 who have been followed up for more than a year were evaluated retrospectively between the group of bipolar hemiarthroplasty, 38 cases out of 60 cases and group of compression hip screw, 40 cases out of 59 cases. The incidence of complications and functional ability according to Merle d'Aubigne scale and the mortality rate were compared using student t-test.
RESULTS
The means of Merle d'Aubigne scale for the hemiarthroplasty group and the compression hip screw group were at the last follow up, 15.0 and 13.6 respectively. The differences were statistically significant (p=0.04). Bipolar group revealed significant differences in general (18%) and mechanical complications (5%) between two groups (p<0.05). The mortality rates were 28% and 22% respectively and there were no significant differences statistically (p>0.05).
CONCLUSION
We consider that primary bipolar hemiarthroplasty would be better method in the treatment of the unstable femoral intertrochanteric fracture with severe osteoporosis but we need much longer follow up.

Citations

Citations to this article as recorded by  
  • Outcomes of Cephalomedullary Nailing in Basicervical Fracture
    Seok Hyun Kweon, Sung Hyun Lee, Seng Hwan Kook, Young Chae Choi
    Hip & Pelvis.2017; 29(4): 270.     CrossRef
  • Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
    Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
    Journal of the Korean Fracture Society.2009; 22(4): 232.     CrossRef
  • Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly
    Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-Jun Kim, Dong-Heon Kim
    Journal of the Korean Fracture Society.2009; 22(4): 239.     CrossRef
  • Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly
    Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-June Kim, Dong-Heon Kim
    Journal of the Korean Fracture Society.2008; 21(3): 232.     CrossRef
  • Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients
    Duk-Hwan Kho, Ju-Yong Shin, Ki-Hwan Kim, Jun-Hyuck Lee, Dong-Heon Kim
    Journal of the Korean Fracture Society.2007; 20(2): 129.     CrossRef
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Bipolar Hemiarthroplasty for the Femur Neck Fractures in Patients Aged Around Ninety
Hyung Ku Yoon, Duck Yun Cho, Dong Eu Shin, Jae Haw Kim, Jin Soo Lee, Jae Hyung Kim
J Korean Fract Soc 2004;17(3):209-213.   Published online July 31, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.3.209
AbstractAbstract PDF
PURPOSE
To evaluate the functional changes, postop delirium and complications after cemented bipolar hemiarthroplasty for the femur neck fractures in patients aged around ninety.
MATERIALS AND METHODS
Between May 1995 and April 2002, of the twenty seven patients, 17 who follow-up for at least one year were included in this study. Walking ability, activity of daily living, mental status, chronic illness, postoperative delirium and complications were evaluated retrospectively using Yoon's walking class, ADL scale, MMSE-K score, ASA classification, DSM IV respectively.
RESULTS
The walking ability was decreased to 2.4 from 3.3 tendency of reliance in ADL scale was increased to 8.3 from 4.5, MMSE-K score was decreased to 15.9 from 21.7. There was no significant change in status of chronic illness. Postoperative delirium occurred in eight (47%) cases and all of them recovered completely. complications included bladder problem in eleven (66%) cases, temporary respiratory distress in two (12%) cases, hip dislocation in two (12%) cases, infection in one (6%) case. Overall thirteen (78%) cases were able to walk with supports.
CONCLUSION
This study indicates that physicians treation femur neck fractures in patients aged around ninety must anticipate worsening of the functional changes more especially in regard to walking level, activity of daily living and mental status, little changes of chronic disease status, complete recovery of postop delirium and high complication rate
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The Problems of Plate Fixation in the Management of Periprosthetic Femoral Fracture
Myung Sik Park, Byung Wan Choi, Hyun kyung Bae, Jong Hyuk Park
J Korean Soc Fract 2003;16(2):148-154.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.148
AbstractAbstract PDF
PURPOSE
The purpose was to evaluate the postoperative periprosthetic femur fracture of hip arthroplasty and relative problems of management using plate fixation. MATERIAL AND METHOD: We reviewed 37 cases of femoral fractures out of 1,270 (1,183 primary hips and 97 revision hips) hips which received hip arthroplasty during the observation period (1985~1998). We classified them according to the stability and the location of the fractures related to the stem tip: Proximal (I), middle (around stem) (II) and distal (III). Then we subclassified the fractures as cortical perforation or a fissure, undisplaced (A), displaced (B) and unstable prosthesis (C). we managed periprosthetic fracture with splint applied or cerclage proximal fracture (type I), plate fixation and bone grafts in the stem tip (type II) or distal fracture (type III). In unstable fractures, we revised them with long fluted stems.
RESULT
The average union time is 3.1 months (range, 2~6.2 months). After management of fracture with plate showed 5 complications, two nonunion and three refractures. The causes of nonunion are early weight bearing and a too short plate. The causes of refracture are screw fixation and empty hole just distal to stem tip. The other caused by the roles of stress riser in proximal screw of blade plate in management of supracondylar fracture.
CONCLUSION
We recommend the use of cerclage band system or fixed in a more proximal site in long plate and bone graft. In unstable prosthesis, we had taken a best results after revised with distal fluted stem, in which we don't need further distal stability like a additional cerclage or locking screw and additional bone graft.
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Total Hip Arthroplasty Following Acetabular Fracture
Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Dong Oh Ko, Jin Woong Yi
J Korean Soc Fract 2003;16(2):121-127.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.121
AbstractAbstract PDF
PURPOSE
We evaluated the results of secondary total hip arthroplasty (THA) after acetabular fracture. MATERIAL & METHODS: Twenty cases of THA were performed to treat acetabular fracture as a secondary treatment after conservative management (6 cases) or internal fixation (14 cases). The mean follow up period was 5 years 2 months. The cause of secondary THA was post traumatic arthritis in 15 hips and osteonecrosis of the femoral head in 5. Cementless acetabular cup was used in 18 cases and cemented in 2 cases. Cementless femoral component was used in 18 cases and cemented in 2 cases. Serial Harris hip score (HHS), pain, limb length discrepancy and radiographs were evaluated.
RESULTS
HHS improved from 57 points to 91 points. Osteolysis in the acetabular component occurred in 2 cases and 5 cases in the femoral component. Loosening occurred in 2 cases of cemented acetabular components and 1 case in the femoral component. In this study, 3 cases (15%) required revision of the acetabular component and 2 cases (10%) of the femoral component.
CONCLUSION
The clinical results of THA after acetabular fracture was inferior to that of conventional arthroplasty. The secure cementless acetabular fixation with proper bone grafting is mandatory to improve the survival of acetabular component.
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Primary Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fracture of the femur in Elderly patients
Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Seong Tae Cho, Kwang Young Choi
J Korean Soc Fract 2003;16(1):37-44.   Published online January 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.1.37
AbstractAbstract PDF
PURPOSE
The purpose of this study was to evaluate the effectiveness and advantage of bipolar hemiarthroplasty in treatment of unstable femoral intertrochanteric fracture in elderly patients.
MATERIALS AND METHODS
We reviewed 93 patients and followed up more than one year. Group I(n=34, Singh index <3 with more than 70 year old) were treated by bipolar hemiarthroplasty. Group II(n=20) with same condition were treated by compression hip screw. Group III(n=39, Singh index >4 with more than 70 year old) were treated by compression hip screw.
RESULTS
Group I and III patients showed satisfactory result over than good by merle D 'Aubigne hip rating scale. Among Group II(n=20), 16 cases showed under 'poor 'according to functional scale. Complication was 1 cases in group I, 19 cases in group II and 8 cases in group III.
CONCLUSION
We suggest bipolar hemiarthroplasty as first choice of treatment for osteoporotic elderly patients with unstable intertrochanteric fracture, especially who have combined medical problems or poor general condition.

Citations

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  • Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
    Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
    Journal of the Korean Fracture Society.2024; 37(3): 144.     CrossRef
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Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Fractures in Elderly Patients
Duk Hwan Kho, Kyou Hyeun Kim, Ju Young Shin, Sin Woo Lim, Dong Heon Kim
J Korean Soc Fract 2003;16(1):22-28.   Published online January 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.1.22
AbstractAbstract PDF
PURPOSE
The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the elderly patients.
MATERIALS AND METHODS
From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrochanteric fractures.
RESULTS
The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation.
CONCLUSION
Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.

Citations

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  • Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly
    YoungJi Ko
    Geriatric Orthopaedic Surgery & Rehabilitation.2019;[Epub]     CrossRef
  • A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
    Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
    Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447.     CrossRef
  • Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
    Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
    Hip & Pelvis.2012; 24(1): 45.     CrossRef
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Treatment of bone cystic change with femoral head fracture in Neurofibromatosis patient
Jae Do Kang, Hyung Chun Kim, Chi Wook Kyoung, Hyun Chul Seo
J Korean Soc Fract 2002;15(3):427-431.   Published online July 31, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.3.427
AbstractAbstract PDF
Cystic change on femoral head and neck in neurofbromatosis patient is rare case. Scoliosis is the most common bony lesion. Others are appeared at changes of out feature in long bone shaft. Bone cyst with bone fracture are treated with non operation or external fixation, osteotomy, curettage, partial and complete excision of cyst capsule, steroid injection therapy, bone graft, internal fixation, arthroplasty. We have experienced a case of bone cystic change on femoral head and neck with femoral head fracture and acetabular lesion in neurofibromatosis patient treated with total hip arthroplasty who was acceptable result.
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Comparison Study between Internal Fixation with Compression Hip Screw and Bipolar Hemiarffiroplasty in Unstable Intertrochanteric Fracture
You Sung Suh, Sai Won Kwon, Ho Won Jung, Jong Seok Park, Byung Ill Lee
J Korean Soc Fract 2001;14(4):584-591.   Published online October 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.4.584
AbstractAbstract PDF
PURPOSE
To define the appropriate treatment of unstable intertrochanteric fracture for aged patients by conducting a clinical and roentgenographical comparative analysis of internal fixation with compression hip screw and primary bipolar hemiarthroplasty.
MATERIALS AND METHODS
38 patients aged 65 or above with intertrochanteric fracture of Singh index below grade III or bone mineral density(BMD) -3.0 who had both severe osteoporosis and unstable fracture, from the period of January 1995 to January 2000. The 38 patients had either internal fixation with compression hip screw(18 cases, Group I) or primary bipolar hemiarthroplasty(20 cases, Group II), and were followed-up for at least one year afterwards. To prevent postoperative complication, early ambulation was permitted as early as possible to both groups.
RESULTS
The average age was 76(range 65-87) for Group I and 79.8(range 78-92) for Group II, respectively. 19 patients were diagnosed to have I-c fracture, following Evans Classification. 35 cases(92.1%) were given grade III or below according to the preoperative Singh index, while all cases showed severe osteoporosis with average bone density of -4.26(-6.95 ~ -2.54). 60% of Group II were given very good or above diagnosis following Merle d'Aubignè's postoperative functional outcome, compared with 16.7% of Group I, thus showed statistic difference of p=0.006. The average for postoperative Harris hip score was also higher with 77 points(range 43-95) for Group I than with 86 points(range 57-94) for Group II, thus showed statistic difference of p=0.0216.
CONCLUSION
For aged patients with unstable intertrochanteric fracture, primary bipolar hemiarthroplasty is considered to have better clinical and roentgenographical results, and able to decrease local and general complications, compared with internal fixation with compression hip screw.
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Case Report
Lateral Insufficiency Fracture of the Femur caused by Osteopenia & Varus angulation after Hip Arthroplasty: Case Report
Myung Sik Park, Yong Min Kim
J Korean Soc Fract 2001;14(3):358-363.   Published online July 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.3.358
AbstractAbstract PDF
Lateral femoral insufficiency fracture in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component. The presentation of these fractures usually involves the insidious onset of unexplained thigh or groin pain. The insufficiency fracture generally occur at the level of the femoral stem tip on the lateral cortex of the femur. Recommended treatment involves revision to a long stem femoral component. This is the first report of lateral femoral insufficiency fracture simply regarded as periprosthetic fracture of the femur.
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Original Articles
Treatment of intertrochanteric fractures with bipolar hemiarthroplasty in the elderly
Kyou hyeun Kim, Duk hwan Kho, Joon ho Yang, Dong heon Kim
J Korean Soc Fract 2001;14(2):174-180.   Published online April 30, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.2.174
AbstractAbstract PDF
PURPOSE
To compare the timing of ambulation, complications and functional results between the autogenous femoral head graft and the calcar replacement type stem in the severe comminuted fracture of the elderly patients with unstability.
MATERIALS AND METHODS
25 intertrochanteric femoral fracture patients who had bipolar hemiarthroplasty were followed for more than 1 year. 17 patients had autogenous femoral head graft and 8 patients had calcar replacement type stem.
RESULT
The mean operating time for autogenous femoral head graft was 1.7 hours, and calcar replacement type stem was 1.3 hours. Postoperative Harris functional score was 84.1 for the autogenous femoral head graft group and 82.2 for the calcar replacement type stem group.
Discussion
: Both autogenous femoral head graft augmentation and fixation using the calcar replacement type stem result in rigid fixation, which enables the patients to ambulate early and to have low complication rate. Both techniques seem to be effective for the treatment of intertrochanteric fractures.

Citations

Citations to this article as recorded by  
  • Analysis of Missed Fractures by Bone Scan in Elderly Hip Fracture Patients with Osteoporosis
    Tae Hun Lee, Yeong Hyun Lee, Seo Won Kang
    Journal of the Korean Fracture Society.2024; 37(3): 144.     CrossRef
  • Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
    Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
    Hip & Pelvis.2013; 25(1): 44.     CrossRef
  • Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
    Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
    Hip & Pelvis.2010; 22(4): 283.     CrossRef
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Treatment of trochanteric fractures of the femur in osteoporotic patients
Joo Tae Park, Chang Sung So, Jae Yong Byun, Kyung Ho You, Ho Yeun Hwang
J Korean Soc Fract 2001;14(1):16-22.   Published online January 31, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.1.16
AbstractAbstract PDF
PURPOSE
To determine more useful method by comparing the functional recovery and postoperative complications according to operative methods in treatment of unstable trochanteric fracture of the femur with osteoporotic bone.
MATERIALS AND METHODS
Of 45 cases with unstable femoral trochanteric fracture with osteoporosis who had been able to ambulate before injury, we compared postoperative functional recovery and complications between 25 cases treated by cemented bipolar hemiarthroplasty and 20 cases treated by dynamic compression hip screw.
RESULTS
Of 45 cases who had been treated by cemented bipolar hemiarthroplasty and dynamic compression hip screw, the functional results, according to the rating scale of Merle d Aubigne were rated as above good in 23 cases and 14 cases, respectively and postoperative mechanical complications were found in 2 cases and 7 cases, respectively. There was statistically significant difference(P<0.05).
CONCLUSION
Unstable trochanteric fracture of the femur with osteoporotic bone treated by cemented bipolar hemiarthroplasty showed good functional results and few mechanical complications for short term follow-up.
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Primary Bipolar Hemiarthroplasty for the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients
You Sung Suh, Sung Tae Kim, Soo Jae Yim, Yon Il Kim, Soo Kyoon Rah, Chang Uk Choi
J Korean Soc Fract 2000;13(2):222-229.   Published online April 30, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.2.222
AbstractAbstract PDF
PURPOSE
: The purpose of this paper was to present the clinical and roentgenographic results were obtained with bipolar hemiarthroplasty as a primary treatment for comminuted unstable intertrochanteric fracture in elderly patients with severe osteoporosis. The goal of this treatment is early ambulation with early weight bearing to prevent the complications such as a deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore.
MATERIALS AND METHODS
: Twenty consecutive patients who were more than seventy years old with severe osteopotosis and had an comminuted unstable intertrochanteric fractures were treated by primary bipolar hemiarthtoplasty from January 1995 through January 1998 at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital. If there were fractured at the lesser or the greater, a circlage wire or Dall-Miles system (trochanter cable grip system) was passed through the lesser and the greater trochnater to permit its subsequent fixation to the medial and the lateral side of the femoral component. The functional results were judged according to the hip rating scale of Merle d' Aubigne.
RESULTS
: The mean age at operation was 79.8(70 to 92) years old. The most common type according to the Evans classification system was I -d(10 cases, 50%). Singh index was case(5%) of Grade I , 7 cases(35%) of Grade II, 10 cases(50%) of Grade III and 2 cases(10%) of Grade IV. The mean bone mineral density(BMD) was -4.24(-6.95 - -3.17). The functional results in 75% of the patients were rated as excellent, very good, or good and in 25% as fair, poor, or bad.
CONCLUSION
: Primary bipolar hemiarthroplasty for the treatment of comminuted unstable intertrochanteric fractures in elderly patients with severe osteoporosis could return these patients to their pre-injury level of activity quickly, thus obviating the postoperative complications caused by immobilization.

Citations

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  • A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE
    Maheshwar Lakkireddy, Radhakrishna Rapaka, Naveen Gouru, Shivaprasad Rapur
    Journal of Evidence Based Medicine and Healthcare.2015; 2(35): 5447.     CrossRef
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Comparison of Bipolar Hemiarthroplasty and Compression Hip screw on Treatment of Elderly Unstable Intertrochanteric Fractrues
Ik Su Choi, Su In Roh, Dae Yeon Kim, Keun Il Lee, Seung Chan Ko
J Korean Soc Fract 2000;13(1):56-63.   Published online January 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.1.56
AbstractAbstract PDF
PURPOSE
To evaluate and compare the clinical outcomes of bipolar hemiarthroplasty and compression hip screw on elderly with unstable intertrochanteric fractures We evaluated the clinical results of 65-year or older elderly patients with unstable intertrochanteric fractures between Jan. 1993 to Dec. 1997. 23 patients underwent compression hip screw treatment and 19 patients were treated with bipolar hemiarthroplasty. Functional evaluation was conducted at 3, 6 and 12 month after the operation by hip rating scale of Merle d'Aubigne. Complications, time to weight bearing and hospitalization period were also investigated.
RESULTS
For the bipolar hemiarthroplasty group, functional scale of good or above were seen in 74%, 72% and 67% of the group at 3 months, 6 months and 12 months. However in the compression hip screw group, the good or above results were shown in 57%, 52% and 43% of the group, thus showing a functional deterioration as time progresses. Comparing the overall clinical outcome, the bipolar hemiarthroplasty group showed better results, complication occurred in 26 cases of compression hip screw group and 8 cases of bipolar hemiarthroplasty group, showing better outcomes in the bipolar hemiarthroplasty group.
CONCLUSION
Comparing the length of hospital stay, time to weight bearing, complication and functional superiority of the treatment for elderly unstable intertrochanteric fractures, the bipolar hemiarthroplasty showed superior clinical outcomes than the compression hip screw. Moreover, patients with more unstable fractures and more severe osteoporosis showed better clinical results with bipolar hemiarthroplasty.
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Treatment of Periprosthetic Fracture Following Total Elbow arthroplasty
Myung Chul Yoo, Yong Girl Rhee, Yoon Je Cho, Kang Il Kim, Young Lin Cho
J Korean Soc Fract 2000;13(1):193-199.   Published online January 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.1.193
AbstractAbstract PDF
PURPOSE
: To classify the pattern of periprosthetic fracture after total elbow replacement(TER) and introduce the principles of treatment in various fracture patterns.
MATERIALS AND METHODS
: Four patients(1 man and 3 women) were evaluated, who had periprosthetic fractures following total elbow arthroplasty, form July 1997 to October 1998. The incidence of fracture among TERs was 6%(4/62) and the average follow-up period was 1 year 6 months. The locations of periprosthetic fractures were classified according to Hanyu et al. The result were analyzed about the treatment modalities, the period to bony union, elbow motion and complication.
RESULTS
: Type2 and type 3 fractures were treated with closed reduction and hanging splint, whereas type 1 fracture showing loosening of humeral component was treated with revision arthroplasty. Type 4 fracture was treated with open reduction and internal fixation. The period to bone union was 5 months in average. The elbow motion ranged between 7.5degrees to 106.2degrees at the last follow-up. Type 3 showed anterior angulation deformity of 20degrees.
CONCLUSION
: Fracture pattern, stability, and loosing of component should be considered to select treatment modality. In transverse fracture proximal to the humeral stem tip(type 3), open reduction and internal fixation is recommended because of difficulties in maintaining alignment of fracture fragment. Postoperative rehabilitation program is very important to prevent limitation of elbow motion

Citations

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  • Treatment of Periprosthetic Fracture after Total Elbow Replacement Arthroplasty
    Hyunseok Seo, Jin-Hyung Im, Joo-Yup Lee
    Journal of the Korean Fracture Society.2020; 33(2): 110.     CrossRef
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Fractures of the Femur associated with the Hip Arthroplasty
Sung Kwan Hwang, Young Sang Lee, Jin Soo Park
J Korean Soc Fract 1999;12(4):837-843.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.837
AbstractAbstract PDF
Periprosthetic fractures as a complication of hip arthroplasty are uncommon. However, the incidence has been increafed recently especially in cementless or press-fit arthroplasties. The need to achieve a tight fit of the prosthesis in the bone when using cementless component has led to increased risk of periprosthetic fractures. We have experienced periprosthetic fractures occurred in 52 cases(51 patients) among 814 hip arthroplastic from January 1990 to December 1997. Among the 52 cases of periprosthetic fractures, 5 cases were occurred in cemented femoral stem(5 cases among the total 236 cases of cemented femoral stem : 2.1%), and 47 cases were occurred in the cementless type of femoral stem(47 cases among the total 578 cases of cementless type of femoral stem : 8.1%). There were 43 cases of intraoperative fracture and the rest was occurred postoperatively. According to the Johannson classification, type I fractures were 28 cases, type II fractures were 20 cases, and type III fractures were 4 cases. In postoperative periprosthetic fractures, according to the Vancouver classification, type A fracture was 1 case, typeB 1 fractures were 4 cases, typeB2 fractures were 2 cases, and type C fractures were 2 cases. The accurate preoperative templating and prophylactic managemnet of the risk factors are important for reducing the incidence of periprosthetic fractures.
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Cemented Hemiarthroplasty in Femoral Neck Fractures over 70 Years : A Matched-Pair Analysis of unipolar and Bipolar Hemiarthroplasty
Kang Sup Yoon, Seung Baik Kang, Ji Ho Lee, Jin Soo Tark, Hyeok Rhyou
J Korean Soc Fract 1999;12(4):773-779.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.773
AbstractAbstract PDF
PURPOSE
: The goal of treatment in elderly patients with hip fractures is restoration of function We analysed the clinical efficacy of the cemented unipolar hemiarthroplasty and bipolar hemiarthroplalty for the treatment of femoral neck fractures in elderly patients over 70 years. Twenty-four pairs of patients who had a cemented hemiarthroplasty were studied with a retrospective and matched-pair analysis. Half of the patients had received a cemented bipolar hemiarthroplasty and the other half, a cemented unipolar hemiarthroplasty The patients were matched for age, sex, femoral head size, physical status and the ability to walk. At one year follow-up, the frequency of the pain and the limp were 41.7% and 54.2%, respectively, in the unipolar group and 45.8% and 45.8%, respertively, in the bipolar group. The ability to live independently was 66.7% in the unipolar group and 79.2% in the bipolar group. None of these differences were statistically significant. The frequency of the return to the level of function before injury was 37.5% in unipolar group and 45.8% in the bipolar group, which was also not significantly different. Flexion of the hip joint was 96.7+/-6.9 in unipolar group and 101.5+/-7.3 in the bipolar group(p=0.02). Abduction and rotational motion was not significantly different in two groups. There were no revisions in either group. Cemented bipolar hemiarthroplasty did not show better clinical results than cemented unipolar group.

Citations

Citations to this article as recorded by  
  • Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients
    Woong-Kyo Jeong, Sang-Won Park, Soon-Hyuck Lee, Jong-Hoon Park, Suk-Ha Lee, Ji-Hoon Kang, Gi-Won Choi, Won Noh
    Journal of the Korean Fracture Society.2008; 21(1): 8.     CrossRef
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The Clinical Resuts of Bipolar Hemiarthroplasty in Old Age-Femoral Neck Fracture vs. Intertrochanteric Fracture-
Dong Heon Kim, Kyu Cheol Shin, Byeong Chun Chang, Dae Sul Kang
J Korean Soc Fract 1999;12(3):509-515.   Published online July 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.3.509
AbstractAbstract PDF
The peritrochanteric fracture remains one of the most common and potentially devastating injuries in the geriatric population. The goal of treatment is early ambulation to prevent the complications such as pressure sore, pneumonia, deep vein thrombosis, pulmonary embolism and long time hospitalization by open reduction and internal fixation or closed reduction and internal rotation. In femoral neck fracture, many surgeons agree on the bipolar hemiarthroplasty but there is controversy about that treatment in intertrochanteric fracture. We have tried to assess the clinical outcome of bipolar hemiarthroplasty for the intertrochanteric fracture as compared with femoral neck fracture in old age. Ninty-five bipolar hemiarthroplasties were performed at our hospital, between January 1991 and February 1996. We selected 65 patients who had been followed for at least one year. Forty of sixty-five patients had femoral neck fractures and twenty-five of them intertrochanteric fractures. The results were as follows: 1. Regardless of using the cement, the partial weight bearing ambulation time after operation was 10.3 days in femoral neck fracture, 19.5 days in intertrichanteric fracture. 2. At one year follow-up the average Modified Harris Hip Score was 88.9 in femoral neck fracture, and 87.5 in intertrochanteric fracture. 3. Postoperative complications in case of femoral neck fracture included thigh pain in 4 patients, heterotopic ossification in 1, intraoperative fractures of the femoral shaft in 2, leg length inequality in 1 and dislocations after bipolar hemiarthroplasties in 3. And those in case of intertrochanteric fractures were thigh pain in 2 patients, heterotopic ossifications in 2, intraoperative fractures of the femoral shaft in 2 and dislocation after bipolar hemiarthroplasty in 1. 4. There were no statistically significant differences in the clinical functional score and complications between intertrochanteric and femoral neck fracture groups, therefore bipolar hemiarthroplasty can be recommended as one of the treatment of intertrochanteric fracture as well as femoral neck fracture in the elderly patient.
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Bipolar Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Elderly Patients: Uncemented versus Cemented femoral stems
Jae Yeul Choi, Kyung Chul Kim, Hwa Jae Jeong, Bon Seop Koo, Ho Joong Lee
J Korean Soc Fract 1999;12(2):195-202.   Published online April 30, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.2.195
AbstractAbstract PDF
Forty five patients above the age of 60 with displaced femoral neck fractures were treated by bipolar hemiarthroplasty in Kangbuk Samsung hospital from January 1990 to January 1995. We evaluated these patients for comparison of the results between the cemented and uncemented femoral fixation, especially in elderly patients with medical illness or osteoporosis. During a follow up period of more than two years, the authors found less thigh pain(5.2% versus 38%) and slightly higher Harris hip scores(84.5 versus 80.0 points) in the cemented group in comparison with the uncemented group. Radiographic examination showed less radiolucent zones in the cemented group. Comparing the operative time(86.2 versus 83.8 minutes), hospital stay(4.7 weeks versus 5.3 weeks), blood loss(385 versus 381 ml) during the operation. The postoperative mortality rate was 2%, and the follow-up mortality rate was 11% in the first year. There was no significant difference between two groups in mortality rate. Thus in bipolar hemiarthroplasty in elderly patients with displaced femoral neck fracture, we have obtained satisfactory results despite of poor bone condition and osteoporosis except thigh pain. But the follow up period was too short to assess the late complications of the hemiarthroplasty such as acetabular erosion, implant loosening, so long-term follow up will be necessary
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Clinical Results of Cemented Bipolar Arthroplasty in Femur Neck Fractures over 70 Years
Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Jong Wha Yi
J Korean Soc Fract 1998;11(2):313-320.   Published online April 30, 1998
DOI: https://doi.org/10.12671/jksf.1998.11.2.313
AbstractAbstract PDF
There have been much controversy about prosthetic replacement or internal fixation for patients over 70 years old. Authors reviewed and analyzed 45 cases of cemented bipolar hemiarthroplasty in patient over 70 years treated at the Department of Orthopedic Surgery, Sung-Ae General hospital from January 1988 to July 1995. The purpose of this study was to analyse the clinical and radiological results and to detect the motion study of bipolar cup. Follow up period was average 26.1 months, ranged from 24 months to 37 months. The following results were obtained. 1. In clinical evaluation, excellent & good result were in 31 cases(68.6%). 2. In radiologic evaluation, acetabular erosion were in 2 cases and loosening of the femoral component was in 1 case. 3. With time elapsed, the amount of the inner bearing motion was decreasing with preservation of the total joint motion. 4. Complications were idiopathic pain 7 cases, nerve paresis 2 cases, superficial infection 2 cases, intraoperative fracture 1 case, dislocation 1 case, losening 1 case.
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Treatment of Femoral Neck Fractures in the Elderly Patients Aged over 60 years: Comparative Study between Osteosynthesis and Bipola Arthroplasty
You Sung Suh, Byung Woo Kim, Kyung Dae Min, Chi Soo Son, Soo Kyoon Rah, Chang Uk Choi
J Korean Soc Fract 1998;11(1):153-158.   Published online January 31, 1998
DOI: https://doi.org/10.12671/jksf.1998.11.1.153
AbstractAbstract PDF
STUDY DESIGN: Seventy femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary biploar arthroplasty were assessed on complication and functional outcome at final follow up. OBJECTIVE: To compare the results of femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary bipolar arthroplasty retrospectively. To know the indications of each method. SUMMARY OF BACKGROUND DATA: Althrough the osteosynthesis method had preservation of hip joint, primary osteosynthesis method had possibility of major complications as nonunion and avascular necrosis of femoral head.
METHODS
Seventy patients with intra-articular femoral neck fracture were treated with osteosynthesis in 33 patients(group 1) and primary biploar arthroplasty in 37 patients(group 2). A comparartive analysis of age, sex, type of fracture, initial displacement of fracture, method of treatment, fixation device type, quality of reduction, operative time, blood loss at operation, complication and functional outcome at final follow up were performed.
RESULTS
The female was more three times than male. The mean ages were 70.1 years old in group 1 and 73.3 years old in group 2. In group 1, complications such as non-union and avascular necrosis of femoral head were significantly greater in the subcapital fractures and Garden's stage 3,4 than the transcapital fractures and Garden's stage 1,2. In operative method, blood loss and operative time were significantly greater in the group 2 than in the group 1. Seven major complications (avascular necrosis: 6 cases, non-union: 1 case) occurred in group 1, two major complications(death: 2 cases) occurred in group 2. The functional outcomes were superior to the group 2, but it may be due to high complication rates in group 1.
CONCLUSIONS
This study suggests that the important factors that influenced the clinical results were type of fracture, initial displacement of fracture, quality of reduction. So in relatively poor arthroplasty.
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Experience with Bipolar Hemiarthroplasty in Femoral Neck Fracture in the Elderly Patients: Correlation Between Preoperative Medical Conditions and Postoperative Functional Results of Hip
Kwang Hee Lee, Se Dong Kim, Dong Chul Lee, Duk Seop Shin
J Korean Soc Fract 1998;11(1):143-152.   Published online January 31, 1998
DOI: https://doi.org/10.12671/jksf.1998.11.1.143
AbstractAbstract PDF
The displaced femoral neck fracture remains a major challenge to orthopedic surgeons, as the elderly population is increasing. Elderly patients with femoral neck fractures often have other medical conditions, fragile bones, and poor compliance. Thus, for elderly patients who need early ambulation and funtional recovery, bipolar prosthesis is accepted as an appropriate treatment. We report a study of 58 cases of bipolar hemiarthroplasty with a femoral neck fracture and a physiologic age older than 65 years from January 1991 to May 1996. The purpose of this study is to evaluate the functional outcome of bipolar hemiarthroplasty and correlation between preoperative medical conditions and Harris hip score in femoral neck fractures in the elderly patients. The results obtained were as followings. 1. 90% of patients had uncontrolled medical conditions. Cardiovascular and pulmonary disease were main preexisting medical conditions. 2. The preoperative medical conditions were important deteminants for the functional results after bipolar hemiarthroplasty. 3. Dislocated bipolar prosthesis needed open reduction or revision to total hip arthroplast due to disassembly of the prosthesis caused by attempted closed reduction.

Citations

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  • Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -
    Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi
    Journal of the Korean Fracture Society.2011; 24(1): 16.     CrossRef
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Comparison of Hemiarthroplasty and Compression Hip Screw on Elderly Unstable Intertrochanteric Fractures
Chung Nam Kang, Jong Oh Kim, Dong Wook Kim, Young Do Koh, Sang Hoon Ko, Ki Woong Lee
J Korean Soc Fract 1997;10(4):738-745.   Published online October 31, 1997
DOI: https://doi.org/10.12671/jksf.1997.10.4.738
AbstractAbstract PDF
Intertrochanteric fractures of the femur usually occur in the elderly and osteoporotic patients. These appear to be increasing in frefuence and are usually unstable. Sixthy two cases were treated ai our hospital from September 1993 through October 1995. 29 elderly patients underwent bipolar hemiarthroplasty and 33 patients underwent internal fixation with compression hip screw(C.H.S). The results were as follows ; 1. Functional results according to hip rating scale of Merle D,Aubiigne was superior in bipolar group. 2. The incidence of postoperative complications was much fewer in bipolar group than in compression hip screw group. 3. In casees of definite osteoporosis with Singhs index below 3 and Evans unstable type frartures, the incidence of mechanical complications was increased, especially in compression hip screw group. 4. There was no siginificant difference between 2 groups in operative time and blood loss.

Citations

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  • Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
    Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
    Hip & Pelvis.2013; 25(4): 274.     CrossRef
  • Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between Femoral Neck Fracture and Intertrochanteric Fracture -
    Chae-Hyun Lim, Young-Yool Chung, Jeong-Seok Kim, Chung-Young Kim
    Hip & Pelvis.2013; 25(1): 44.     CrossRef
  • Hip Arthroplasty Using Collarless Polished Tapered Stem -Minimum 2 Years Follow-up Results-
    Yerl-Bo Sung, Jung-Yun Choi, Su-Chan Oh
    Hip & Pelvis.2012; 24(1): 18.     CrossRef
  • Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients
    Sung-Hwan Kim, Soo-Won Lee, Gyu-Min Kong, Mid-Um JeaGal
    Hip & Pelvis.2012; 24(1): 45.     CrossRef
  • Cemented Bipolar Hemiarthroplasty for Intertrochanter Fracture in Elderly Patients - Minimum 2-Years Follow-up Results -
    Sung Kwan Hwang, Dong Hyun Kang, Tae Yeon Cho, Chang Ho Yi
    Hip & Pelvis.2010; 22(3): 209.     CrossRef
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