Calcar Replacement Hemiarthroplasty versus Proximal Femoral Nail for Treatment of Unstable Intertrochanteric Fractures in Elderly | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 07 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.373827.2163 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mohamed Sayed Hamdy  1; Adnan Abd El Aleem El-Sebaay2; Mohammed Gamal Abd-ElKader3
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| 1Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. | ||||
| 2Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| 3Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University Egypt | ||||
| Abstract | ||||
| Background: Intertrochanteric fractures occur with low-energy trauma because of decreased bone quality and deterioration of histological structure on the basis of osteoporosis. The aim of this work was to compare proximal femoral nail and calcar-replacement hemiarthroplasty in treatment of unstable intertrochanteric fractures of elderly regarding the surgical techniques, clinical and radiological outcomes, complications (intra- and post- operative), functional hip outcome and patient satisfaction. Methods: This Prospective Randomized Study was conducted on Thirty patients with unstable intertrochanteric hip fracture. Patients were divided into two equal groups: Group I were treated with bipolar calcar hemiarthroplasty, and Group II were treated with a proximal femoral nail. Results: at 3 months, harris hip score was significantly higher in hemiarthroplasty group (p < 0.001*). However, at 6 months and 12 months, the differences in score were not statistically significant (p > 0.05). At 24-month Harris hip score was significantly higher in PFN group then hemiarthroplasty group (p=0.04). The mean duration of surgery was significantly shorter in the PFN group compared to the Hemiarthroplasty group (p = 0.041). The mean blood loss during surgery was significantly lower in the PFN group compared to the Hemiarthroplasty group (p<0.001). Conclusions: PFN and calcar-replacement hemiarthroplasty are two safe and effective fixation methods for treating the elderly with intertrochanteric fractures. Both PFN and calcar-replacement hemiarthroplasty achieve stable fracture fixation, reduce pain, less post-operative complications and restore function of the hip joint. | ||||
| Keywords | ||||
| Calcar Replacement; Elderly; Hemiarthroplasty; Intertrochanteric Fractures | ||||
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