Functional Outcomes of Primary Cemented Bipolar Hemiarthroplasty for Comminuted Intertrochanteric Femur Fractures in Elderly Patients: A Prospective Study.
- 1Department of Orthopaedics, Ballari Medical College and Research Centre, Ballari, Karnataka, India.
- 2Department of Orthopaedics, Raichur Institute of Medical Sciences, Raichur, Karnataka, India.
Abstract
Intertrochanteric fractures are among the most common fragility fractures in the elderly, and comminuted, unstable patterns are difficult to manage with fixation alone because of poor bone stock and loss of posteromedial support. While intramedullary devices, such as the proximal femoral nail remain the standard of care, primary hemiarthroplasty has been proposed as an alternative when early weight-bearing is a priority, though supporting evidence remains limited. This study evaluated the clinical and functional outcomes of primary cemented bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures. This prospective observational study was conducted in the Department of Orthopaedics of a tertiary-care teaching hospital over 18 months (May 2023-February 2025), with post-operative follow-up to 6 months. Thirty patients aged 60 years or older with Boyd and Griffin type II or III intertrochanteric fractures underwent primary cemented bipolar hemiarthroplasty through a posterolateral approach. Functional outcome was assessed using the Harris Hip Score, alongside operative parameters, complications, limb shortening, and time to full weight-bearing. The mean age was 69.88 years ± 6.38 years (15 males, 15 females). Mean operative time was 84.07 ± 10.26 min, and mean estimated blood loss was 287.67 ± 110.63 mL; 46.7% of patients required transfusion. Post-operative complications occurred in 20% of patients, most commonly abductor weakness (16.7%). Mean limb shortening was 0.98 ± 0.58 cm, and mean time to full weight-bearing was 6.21 ± 1.47 days. At final assessment, 13.3% of patients had excellent, 30% good, 36.7% fair, and 6.7% poor Harris Hip Scores; 13.3% died during follow-up. Greater blood loss and transfusion requirement were significantly associated with post-operative complications (P = 0.028 and P = 0.046, respectively). Primary cemented bipolar hemiarthroplasty allowed early weight-bearing and produced predominantly fair-to-good functional outcomes in these selected elderly cohort with comminuted intertrochanteric fractures, with an acceptable complication profile. Given the small sample size and absence of a comparison group, these findings support the feasibility of hemiarthroplasty in this setting rather than its superiority over internal fixation.
Related
- Prospective comparison of PFBN and PFNA in treating elderly unstable intertrochanteric fractures
- HEMIARTHROPLASTY FOR PROXIMAL FEMORAL FRACTURES IN CENTENARIANS: A CASE SERIES WITH 12-MONTH SURVIVAL AND FUNCTIONAL OUTCOMES
- Surgical Technique – The “Derriere View” for Evaluation of Guidewire Position in Cephalomedullary Nailing of Intertrochanteric Femur Fractures
- Ligamentotaxis-Based Dynamic External Fixation for Comminuted Intra-articular Fractures of the Proximal Phalanx Base of the Thumb: A Report of Two Cases.
- Reverse Obliquity Intertrochanteric Hip Fractures: A Technique Guide for Using a Blocking Screw to Enhance Fixation
BibTeX
@article{kumar2026functional,
title = {{Functional Outcomes of Primary Cemented Bipolar Hemiarthroplasty for Comminuted Intertrochanteric Femur Fractures in Elderly Patients: A Prospective Study.}},
author = {A S Kiran Kumar and B Sai Vamshi and Bhushan Chickle},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8532},
url = {https://europepmc.org/article/MED/42996993},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Functional Outcomes of Primary Cemented Bipolar Hemiarthroplasty for Comminuted Intertrochanteric Femur Fractures in Elderly Patients: A Prospective Study.
AU - A S Kiran Kumar
AU - B Sai Vamshi
AU - Bhushan Chickle
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8532
UR - https://europepmc.org/article/MED/42996993
AB - Intertrochanteric fractures are among the most common fragility fractures in the elderly, and comminuted, unstable patterns are difficult to manage with fixation alone because of poor bone stock and loss of posteromedial support. While intramedullary devices, such as the proximal femoral nail remain the standard of care, primary hemiarthroplasty has been proposed as an alternative when early weight-bearing is a priority, though supporting evidence remains limited. This study evaluated the clinical and functional outcomes of primary cemented bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures. This prospective observational study was conducted in the Department of Orthopaedics of a tertiary-care teaching hospital over 18 months (May 2023-February 2025), with post-operative follow-up to 6 months. Thirty patients aged 60 years or older with Boyd and Griffin type II or III intertrochanteric fractures underwent primary cemented bipolar hemiarthroplasty through a posterolateral approach. Functional outcome was assessed using the Harris Hip Score, alongside operative parameters, complications, limb shortening, and time to full weight-bearing. The mean age was 69.88 years ± 6.38 years (15 males, 15 females). Mean operative time was 84.07 ± 10.26 min, and mean estimated blood loss was 287.67 ± 110.63 mL; 46.7% of patients required transfusion. Post-operative complications occurred in 20% of patients, most commonly abductor weakness (16.7%). Mean limb shortening was 0.98 ± 0.58 cm, and mean time to full weight-bearing was 6.21 ± 1.47 days. At final assessment, 13.3% of patients had excellent, 30% good, 36.7% fair, and 6.7% poor Harris Hip Scores; 13.3% died during follow-up. Greater blood loss and transfusion requirement were significantly associated with post-operative complications (P = 0.028 and P = 0.046, respectively). Primary cemented bipolar hemiarthroplasty allowed early weight-bearing and produced predominantly fair-to-good functional outcomes in these selected elderly cohort with comminuted intertrochanteric fractures, with an acceptable complication profile. Given the small sample size and absence of a comparison group, these findings support the feasibility of hemiarthroplasty in this setting rather than its superiority over internal fixation.
SN - 2250-0685
SN - 2321-3817
ER -