[The clinical effect of bipolar long-stem prosthetic replacement on the treatment of comminuted intertrochanteric fracture of hip in the elderly osteoporotic patients].

OBJECTIVE: To evaluate the clinical effect of bipolar long-stem prosthetic replacement on the treatment of comminuted intertrochanteric fracture of hip in the elderly osteoporotic patients.

METHODS: From March 2000 to August 2003, 18 patients who were more than 72 years old with comminuted intertrochanteric fracture were treated with bipolar long-stem prosthetic replacement. There were 8 males and 10 females (aged from 72 to 91). Fractured fragments of large trochanter and minor trochanter should be preserved during the operation so that the fragments can be fixed with steel wires and insertion of artificial femoral head. The surgical approach and operative technique, the average course of treatment in hospital, the average time to ambulate with full-weight bearing on the operated limb after the operation, complication, and mortality were observed.

RESULTS: All patients were followed up 6 to 28 months (16.2 months on average). The average course of stay at hospital was 16 days. The average time to ambulate was 32 days. The incidence of the pain of the hip joint was one-eighteenth, and one patient due to another disease was unable to walk without using two crutches one month after the surgery. The mortality of the patients was one-eighteenth one year after the surgery.

CONCLUSION: Bipolar long-stem prosthetic replacement for the treatment of comminuted intertrochanteric fractures in the elderly osteoporotic patients proves to be a suitable alternative. Patients have better prognosis, early full-weight bearing, rapid rehabilitation, and fewer complications.