Intertrochantric femur fracture in elderly treated with bipolar vs dhs - a prospective study

femur is malunions, nonunions, respiratory tract infection and bed sores etc. treatment modality like DHS is time tested but with availability of better hemiarthroplasty techniques and implant mortality and morbidity can be reduced. We aimed at evaluating the advantages and disadvantages of hemiarthroplasty over dynamic hip screw for management of IT fracture femur. Methods: 60 yrs and above patients who were admitted and operated between feb 2010 to feb 2012 and had fulfilled the inclusion criteria were enrolled for this study.Case selection was random. Bipolar Hemiarthroplasty:Total numbers of patient 16 of mean age of 80.2 yrs and F:M ratio is 9:7. Mean follow up period of 1.1 yrs. DHS: Total numbers of patients 21 of mean age of 70.1 yrs and F:M ratio of 6:15.mean follow up period of 1.2 yrs. Harris Hip Scoring System assessed post operatively. Results: Bipolar group:1 had superficial wound infection, no one had deep infection or pulmonary infection.1 had bed sore . After 6 months fair result in 2 patients, good result in 4 patients and excellent result in 10 patients. Eventually all had good to excellent result after 1 yr. DHS Group :3 had bed sore,.1 had lacunar infract.1 was admitted for physiotherapy at 6th month for gait training and muscle strengthening.1 had palpable implant and pain in hip, implant removal was done after 1 yr,. After 6 months,2 had poor results, 2 had fair results,13 had good results and 2 had excellent result at the end of 1 yr patient who follow up all had good to excellent results. Conclusion: Functional recovery was delayed with internal fixation group. Early post operative harris hip score were good in patients treated with hemiarthroplasty as compared to internal fixation group but at the end of 1 year score was comparable.Post operative complications were more internal fixation group than hemiarthroplasty group and were comparable with other studies. Thus in conclusion, primary hemiarthroplasty does provide a stable, pain-free, and mobile joint with acceptable complication rate as seen in our study; however a larger prospective randomised study comparing the use of dynamic hip screw devices against primary hemiarthroplasty for unstable intertrochantric fractures will be needed.