Functional outcome of long stem cemented hemiarthroplasty in the management of unstable pertrochanteric femur fractures in geriatric patients.

Abstract

<h4>Background</h4>Unstable pertrochanteric fractures in elderly patients with osteoporosis are associated with high rates of fixation failure, prolonged immobilization, and increased morbidity. Primary long-stem cemented hemiarthroplasty has emerged as an alternative that allows early mobilization and predictable functional recovery. The present study aimed to evaluate the functional outcome of primary long-stem cemented hemiarthroplasty in elderly patients with unstable pertrochanteric femur fractures.<h4>Methods</h4>This prospective interventional cohort study included 30 geriatric patients (>60 years) with unstable pertrochanteric fractures treated using long-stem cemented bipolar hemiarthroplasty. Patients were followed for six months. Functional outcome was assessed using the modified Harris Hip Score (mHHS) and pain using the Visual Analogue Scale (VAS). Operative time, blood loss, time to mobilization, and complications were recorded.<h4>Results</h4>The mean age was 71.27 ± 7.89 years, with a female predominance (73.3%). Mean operative time was 99.5 ± 12.8 min and mean blood loss was 336.7 ± 28.5 mL. Early mobilization was achieved in most patients (POD 1-2 in 89.6%). Mean mHHS improved from 74.8 at 2 weeks to 88.8 at six months. VAS scores showed significant pain reduction over follow-up. One death (3.3%) was recorded.<h4>Conclusion</h4>Primary long-stem cemented hemiarthroplasty provides stable fixation, allows early mobilization, and results in excellent short-term functional outcomes in elderly patients with unstable pertrochanteric fractures.