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Abstract：
Background In the case of elderly patients suffering from osteoporosis, the primary objectives of addressing comminuted intertrochanteric fractures are centered upon the recuperation of the patients\' pre-fracture levels of activity, the expeditious promotion of full weight-bearing capacity, and the minimization of the likelihood of further surgical interventions. The adoption of hemiarthroplasty as a method for comminuted intertrochanteric fractures is proven as a means of hastening the recovery process, enabling early weight-bearing and mitigating the problems associated with extended bed rest. The outcomes that resulted from the application of this technique will be evaluated and analyzed as part of this study\'s objectives. Methodology A prospective study was conducted over the course of one year at a tertiary care hospital in the northern part of India. The study comprised a total of 30 individuals; however, unfortunately, one of the patients could not be located for further analysis. Patients of either gender in the age group of over 60 years old and with unstable osteoporotic intertrochanteric fractures were included (AO Foundation/Orthopaedic Trauma Association type 31-A2.2, A2.3, or 31-A3 group). Patients were observed at one, three, and six months after the surgical operation. The Harris Hip Score (HHS) was used for the functional outcome evaluation. Results Throughout the course of our analysis, we saw an increase in the overall HHS that was statistically significant. The HHS exhibited a mean value of 34.33 during the period of discharge, with a range of 32 to 39. It increased to 55.34 (range = 52-59) after one month of follow-up, and it continued to rise to 85.03 (range = 63-89) after three months of follow-up. It is important to note that the mean HHS reached 95.24 (range = 63-98) by the sixth month of follow-up. The study showed a statistically significant upward trend in HHS scores across all time periods (p < 0.001). Conclusions Early postoperative ambulation was made possible with the use of cemented prostheses, which contributed to patients\' overall improvements in their functional results. Cemented primary bipolar hemiarthroplasty has emerged as a promising alternative for the treatment of unstable intertrochanteric fractures. The enhanced functional outcomes measured by the HHS provide evidence of this. The transtrochanteric technique has shown advantages in retaining the anatomical integrity of external rotators, minimizing the necessity for their resection, and reducing the danger of sciatic nerve injury. These advantages were displayed by the transtrochanteric approach. Moreover, owing to the implementation of wiring techniques, the larger trochanter could be conserved, resulting in enhanced postoperative recovery and expediting the return to the preoperative condition. When compared with other techniques of internal fixation, the utilization of cemented bipolar hemiarthroplasty demonstrated much-reduced rates of complications, such as the need for further surgery and implant failure.
摘要：
背景：在患有骨质疏松症的老年患者的情况下，解决粉碎性股骨粗隆间骨折的主要目标是恢复患者的骨折前活动水平，迅速提高全部承重能力，以及进一步手术干预的可能性最小化。采用半髋关节置换术作为粉碎性股骨转子间骨折的方法被证明是加快康复过程的一种手段，使早期负重和减轻与延长卧床休息相关的问题。作为本研究目标的一部分，将对应用该技术产生的结果进行评估和分析。方法在印度北部的一家三级保健医院进行了为期一年的前瞻性研究。该研究共包括30个人；然而，不幸的是,无法找到其中一名患者进行进一步分析.纳入年龄在60岁以上的不稳定骨质疏松性股骨转子间骨折患者（AO基金会/骨科创伤协会31-A2.2，A2.3或31-A3组）。患者被观察到在一个，三,手术后六个月。Harris髋关节评分（HHS）用于功能结局评估。结果在我们的分析过程中，我们看到整体HHS的增加具有统计学意义.HHS在出院期间的平均值为34.33，范围为32到39。随访一个月后，它增加到55.34（范围=52-59），经过三个月的随访，它继续上升到85.03（范围=63-89）。重要的是要注意，到随访的第六个月，平均HHS达到95.24（范围=63-98）。该研究显示，在所有时间段内，HHS评分均呈统计学上显著的上升趋势（p<0.001）。结论使用骨水泥假体可以实现术后早期下床活动。这有助于患者功能结果的整体改善。胶结性初次双极半髋关节置换术已成为治疗不稳定股骨粗隆间骨折的有希望的替代方法。HHS测量的增强的功能结果提供了这一点的证据。经转子技术在保留外部旋转器的解剖完整性方面显示出优势，尽量减少切除的必要性，减少坐骨神经损伤的危险。这些优势是通过经转子方法显示的。此外，由于布线技术的实现，可以保留较大的转子，从而增强术后恢复并加快恢复到术前状况。与其他内固定技术相比，骨水泥双极半髋关节置换术的使用率大大降低了并发症的发生率，例如需要进一步的手术和植入失败。
