Gilbert Maroun1, Raja Chaftari2, Jad Chokr1, Charbel Maroun3, Moussa El-Jerdi2, Charbel Saade4. 1. Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon. 2. Department of Orthopedic Surgery, Geitaoui Lebanese Hospital, P.O.Box: 175086, Beirut, 1107 2020, Lebanon. 3. Department of Orthopedic Surgery, Institut de la main Clinique Jouvenet Paris, 6 square Jouvenet, 75016, Paris, France. 4. Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon. cs39@aub.edu.lb.
Abstract
AIM: The aim of our study is to investigate the results of constrained total hip arthroplasty as a primary treatment of intertrochanteric fractures (ITF) in elderly patients with high comorbidities. MATERIALS AND METHODS: Total hip replacement (THR) with a retentive cup was performed on 73 patients with ITF over the age of 54 years who had high comorbidities and a Charlson score above five. Short- and long-term complications were determined by follow-up. Bivariate analysis was conducted in order to determine the possible determinants of mortality and factors associated with comorbidity as measured by the Charlson comorbidities index. RESULTS: Patient demographics that consisted of females (58.9%) (p < 0.04) with the mean age of both males and females demonstrated no statistical significance. The mean hospitalization time and weight bearing time were 11 and 2.67 days, respectively. Only 4.1% needed re-intervention due to re-fracture and none due to prosthesis failure. There was a statistical significance between the comorbidity index and the mortality rate. However, no statistical significance was identified between the comorbidity index and the functional status after constrained THR. CONCLUSION: High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for ITF in elderly patients.
AIM: The aim of our study is to investigate the results of constrained total hip arthroplasty as a primary treatment of intertrochanteric fractures (ITF) in elderly patients with high comorbidities. MATERIALS AND METHODS: Total hip replacement (THR) with a retentive cup was performed on 73 patients with ITF over the age of 54 years who had high comorbidities and a Charlson score above five. Short- and long-term complications were determined by follow-up. Bivariate analysis was conducted in order to determine the possible determinants of mortality and factors associated with comorbidity as measured by the Charlson comorbidities index. RESULTS:Patient demographics that consisted of females (58.9%) (p < 0.04) with the mean age of both males and females demonstrated no statistical significance. The mean hospitalization time and weight bearing time were 11 and 2.67 days, respectively. Only 4.1% needed re-intervention due to re-fracture and none due to prosthesis failure. There was a statistical significance between the comorbidity index and the mortality rate. However, no statistical significance was identified between the comorbidity index and the functional status after constrained THR. CONCLUSION: High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for ITF in elderly patients.
Entities:
Keywords:
Intertrochanteric fractures; Metallic implant; Total hip replacement; X-ray
Authors: Nizar N Mahomed; Jane A Barrett; Jeffrey N Katz; Charlotte B Phillips; Elena Losina; Robert A Lew; Edward Guadagnoli; William H Harris; Robert Poss; John A Baron Journal: J Bone Joint Surg Am Date: 2003-01 Impact factor: 5.284