HEMIARTHROPLASTY AND CERCLAGE WIRING FOR INTERTROCHANTERIC FEMUR
FRACTURE IN ELDERLY AT Prof. Dr. R. SOEHARSO ORTHOPAEDIC HOSPITAL ON 2008 - 2009
( Retrospective Study) Rhyan Darma Saputra*, Ismail Maryanto ** * Resident of Orthopaedic & Traumatology Faculty of Medicine Sebelas Maret University **Staff of Orthopaedic & Traumatology Faculty of Medicine Sebelas Maret University - Dr. Moewardi General Hospital - Prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta Abstract Background: Hip fracture are among the most devastating injuries in elderly, including the intertrochanteric site. Intertrochanteric fracture incidence increased eightfold in men over 80 years of age and increased fivefold in women over 80. Intertrochanteric femoral fractures have been estimated to occur in more than 200,000 patients each year in the United States, with reported mortality rates ranging from 15% to 30%. Aitken reported that intertrochanteric femur fracture were more common in osteoporotic patient. Prosthetic replacement for intertrochanteric fractures has been advocated, but has not gained widespread support. In patients with severe osteoporosis with significant comminution and behavior disorders due to dementia, prosthetic replacement may be considered. Calcar replacement femoral components usually are needed because of loss of most of the femoral neck and possibly the lesser trochanter. Objective : The aim of the study were evaluating the use of hemiarthroplasty and cerclage wiring in prosthetic replacement for intertrochanteric femur fracture in elderly patients performed in Prof. Dr. R. Soeharso Orthopaedic Hospital Patients and Methods: This study evaluates all elderly patients which has underwent hemiarthroplasty and cerclage wiring for intertrochanteric femur fracture in Prof. Dr. R. Soeharso Orthopaedic Hospital. Research conducted a descriptive study with retrospective approach. Results: Nineteen patients were eligible for inclusions and exclusions criteria. 89,47 % patients were at over 65 years of age. Most of the patients only need less than ten days length of stay in hospital. Only 5,26 % patients in nonambulatory for more than 21 days. In the first 2 weeks after treatment, 42,11 % patients had full weight bearing ambulatory, and for the second 2 weeks after treatment 73,68 % patients had full weight ambulatory. Only 15,79 % patients remains in non weight bearing ambulation after four weeks. Post operative complications for this procedure also minimal. Only 5,26 % patients had toeing out leg and 10,53 % patients had a protrusion for the implant. The rest of the patients have no after treatments problems Discussions : Hemiarthroplasty and cerclage wiring procedures are giving advantages in reducing the incidence of prolonged bed rest, prolonged length of stay, and prolonged immobilization for intertrochanteric femur fracture in elderly. It may suitable for intertrochanteric femur fracture in elderly patients, especially with the dementia, due to associated symptomps. Conclusions: Most elderly patients with intertrochanteric fractures have considerable osteopenia, with the low quality of bone. The elderly patient often had a dementia as comorbid factors. The use of hemiarthroplasty and cerclage wiring giving advantages for the patients in calcar replacement for the hip. This procedure also important to avoid after treatment complications for elderly patients Keywords : Inte trochanteric femur fracture, elderly, hemiarthroplasty and cerclage wiring