Vol. 6, Issue 1, Part B (2024)

Introduction: One of the most common ailments of hip joint is fracture neck of femur. In recent years incidence of comminuted intertrochanteric femur fractures are rising with rising number of geriatrics population in the country as well as worldwide, and responsible for one of the commonest mode of morbidity and mortality in this age group. Comminuted intertrochanteric femur fractures are challenging fracture to fix for orthopaedic surgeons. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation and can aid in the recovery of biomechanical function of the hip. This study was designed to evaluate primarily outcome of hemiarthroplasty as well as constructing strength of abductors around hip joint for better functioning hip rather than just replacement by assessing quality of life and range of function in operated limb.

Aim: The aim of this study was to evaluate clinical outcomes such as abductor power, ambulatory ability and radiologic outcomes including the union of the trochanteric fragment in hemiarthroplasty in elderly patients who had unstable intertrochanteric femur fracture.

Materials and Methods: This prospective study included data of 25 patients from BJ Medical college, Civil Hospital, Ahmedabad between the date of 1 May 2019 to November 2021. Patients were included as per the inclusion and exclusion criteria. Hemiarthroplasty using cemented as well as un-cemented prosthesis were used. The functional outcome of surgery was assessed with Harris Hip Score postoperatively, visual analogue scales post operatively. Followup was conducted for 2 years. The power of the abductor was evaluated using Medical Research Council scale.

Results: At the end of 1year 20/25 (80%) patients showed excellent scores as well as combined 24/25 (96%) patients had good and excellent results, per Harris hip score, most patients with 23 out of 25 patients had no pain at all. The fixation of GT and abductor mechanism repair led to improvement in abductor muscles function with 76% patients developing full power (5) as well as combined Grade 4 and 5 patients’ total number 23 (92%) had got almost better function of abductors.

Conclusion: From this prospective study, we have found that there is early weight bearing function results in less reliability and dependency on others, as well as better functioning of hip joint and abductor power results in more stability of hip joint. This study also found that patients having early mobilization rates which results in less chances of immobility related complications like DVT. This study shows that with the repair of abductor mechanism using fixation of fracture fragments of Greater trochanter (GT), there is better functioning of hip joint and strength of hip joint over longer period.