Functional outcome of internal fixation versus hemiarthroplasty in intertrochanteric femoral fractures in elderly

Introduction: Intertrochanteric fractures make up 45 percent of all hip fractures and are the major cause of disability in elderly. Mainstay of treatment of intertrochanteric fractures is internal fixation but in recent years hemiarthroplasty has emerged as one of the treatment modalities for unstable fractures. Aims and objectives: To compare the functional outcome of internal fixation and hemiarthroplasty in the intertrochanteric fractures in geriatric population.
Materials and methods: We prospectively evaluated the clinical and functional outcomes of internal fixation and hemiarthroplasty in patients with unstable intertrochanteric fractures. 55 patients underwent internal fixation and 30 patients hemiarthroplasty. The patients were followed up for six months and functionally assessed using the Harris hip score.
Results: Both the groups were comparable with respect to demographic data. Eight patients were lost to follow up and nine patients expired within six months. Harris hip score analysis revealed statistically significant difference in favor of hemiarthroplasty group within the first three months. However, this was reversed at six months analysis of Harris hip score.
Conclusion: Although cases with hemiarthroplasty achieved a better level of activity in the beginning, cases with internal fixation reached a comparable level of activity within a short period of time, faster than those treated with hemiarthroplasty, displaying a better level of activity in the end.