Fixation distale par tige modulaire sans ciment sans reconstruction du calcar dans les fractures pertrochantériennes instables chez les patients de plus de 75 ans - 28/01/19
Cementless distal fixation modular stem without reconstruction of femoral calcar for unstable intertrochanteric fracture in patients aged 75 years or more
, Jia Liu b, Yong Wang c, Shuo Feng a, Xiang-Yang Chen a, Kai-Jin Guo a, Jun-Ying Sun dAbstract |
Introduction |
Hemiarthroplasty (HA) using standard-length femoral stem with reconstruction of femoral calcar or using calcar-replacing prosthesis for unstable intertrochanteric fractures in elderly patients is a viable option. However, both of the techniques increase the complexity of procedure, operative trauma and complication. This study evaluated the clinicoradiological results of the MP-Link cementless distal fixation modular prosthesis without reconstruction of femoral calcar for unstable intertrochanteric fracture in patients aged 75 years or more.
Hypothesis |
Bipolar HA using the MP-Link cementless distal fixation modular prosthesis for unstable intertrochanteric fractures in patients aged 75 years or more, do not need to reconstruct the femoral calcar.
Materials and Methods |
Forty-two patients (42 hips) underwent bipolar HA using the MP-Link cementless distal fixation modular prosthesis for unstable intertrochanteric fractures from January 2008 to January 2012. Five (11.9 %) patients were lost to follow-up. The 37 remaining patients (37 hips) were available for evaluation. The mean age was 83.9±5.2 years. Their clinicoradiological data were prospectively gathered.
Results |
All of 37 patients, 4 patients (10.8 %) died within 1 year postoperatively. At the final follow-up, 31 (83.8 %) out of 37 patients were regained preoperative ambulatory status; the mean Harris hip score (HHS) of the 15 patients who died during the follow-up period of 7–59 months, was 84.5±2.4 points; the 22 healthy patients were followed for 68.6±14.7 months, with mean HHS of 84.6±2.8 points. Radiologically, none of stems had evidence of loosening; 16 stems had subsidence of 2–3mm without clinical significance; the bone ingrowth fixation was achieved in 24 patients and stable fibrous fixation in 13 patients.
Discussion |
Bipolar HA using the MP-Link cementless distal fixation modular prosthesis for unstable intertrochanteric fractures in patients aged 75 years or more, without reconstruction of the femoral calcar, may achieve a satisfactory clinicoradiological outcome, and could regain preoperative ambulatory status in most patients (83.3 %).
Level of Evidence |
IV, Retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Cementless modular stem, Intertrochanteric fracture, Old age
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 105 - N° 1
P. 20 - février 2019 Retour au numéro
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