A study on functional outcome of cemented bipolar hemiarthroplasty and proximal femoral nailing for intertrochanteric fractures of femur in elderly patients 60-90 years

Background: Intertrochanteric fractures are common in elderly patients, often resulting from low-energy falls and exacerbated by osteoporosis. Procedures like bipolar hemiarthroplasty (BHA) and proximal femoral nailing (PFN) present unique benefits and challenges. The aim of the study was to compare the functional outcome of intertrochanteric fracture treated with proximal femoral nail and cemented bipolar hemiarthroplasty. Methods: A longitudinal observational study was conducted among patients with complaint of an intertrochanteric fracture between March 2021 and August 2022. A total of 24 patients were selected based on particular inclusion and exclusion criteria and divided into two groups of 12. After the respective procedure, patients were monitored for a duration of 5 months, both preoperatively and postoperatively at 1, 3, and 5 months. The collected data included demographic data, clinical data as well as Harris hip score which was then entered into excel sheets and then analyzed using EZR version 1.54 software. Results: The present study included 24 patients of which 37.5% were males and 62.5% were females with a mean age of 78.17±9.13 years. The mean blood loss observed was 203.75±65.99 ml, mean surgery time was 96.42±26.02 minutes, and mean number of days needed to bear full weight was 28.21±20.42 days. Of the fracture patterns, 31-A2 was the most common encountered (54.2%). The mean amount of blood loss among participants in the PFN group was 152.50±24.17 ml and in the bipolar group the mean blood loss was 255±52.83 with this difference being statistically significant (p<0.05). Conclusions: This study found significant intraoperative blood loss differences between PFN and CBH in older intertrochanteric fracture patients. The statistically significant reduction in blood loss makes PFN a safer surgery for this sensitive group.