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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