S Grote1, F Stegmeyer, V Bogner, P Biberthaler, W Mutschler. 1. Chirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland. stefan.grote@med.uni-muenchen.de
Abstract
BACKGROUND: The optimal treatment strategy for unstable trochanteric fractures in the elderly is still controversial because of the frequent failure of osteosynthesis. METHODS: A cohort of patients with unstable trochanteric fractures who were treated with cemented hemiarthroplasty and presented in our department during the period 2003-2009 was analyzed. Complications, reoperations, walking ability and full weight bearing were documented. RESULTS: A total of 91 patients were included (mean age 87.7±6.8 years) and predominantly 31A2 fractures (89%) were treated. There were 3.3% reoperations in the cohort and the 30 day mortality was 5.5%. At least 1 general complication occurred in over 50% of the patients. However, 30% of the patients had lower urinary tract infections, disturbances of electrolyte balance or transitory psychotic symptoms. On average full weight bearing could be performed at 3.5 (±3) days after the operation. CONCLUSION: Cemented hemiarthroplasty is a safe treatment strategy for unstable trochanteric fractures in the elderly, which allows early full weight bearing. Because of frequent general complications, more interdisciplinary units and centres of excellence are needed to handle this challenging cohort.
BACKGROUND: The optimal treatment strategy for unstable trochanteric fractures in the elderly is still controversial because of the frequent failure of osteosynthesis. METHODS: A cohort of patients with unstable trochanteric fractures who were treated with cemented hemiarthroplasty and presented in our department during the period 2003-2009 was analyzed. Complications, reoperations, walking ability and full weight bearing were documented. RESULTS: A total of 91 patients were included (mean age 87.7±6.8 years) and predominantly 31A2 fractures (89%) were treated. There were 3.3% reoperations in the cohort and the 30 day mortality was 5.5%. At least 1 general complication occurred in over 50% of the patients. However, 30% of the patients had lower urinary tract infections, disturbances of electrolyte balance or transitory psychotic symptoms. On average full weight bearing could be performed at 3.5 (±3) days after the operation. CONCLUSION:Cemented hemiarthroplasty is a safe treatment strategy for unstable trochanteric fractures in the elderly, which allows early full weight bearing. Because of frequent general complications, more interdisciplinary units and centres of excellence are needed to handle this challenging cohort.
Authors: Christophe Sadowski; Anne Lübbeke; Marc Saudan; Nicolas Riand; Richard Stern; Pierre Hoffmeyer Journal: J Bone Joint Surg Am Date: 2002-03 Impact factor: 5.284