Hemiarthroplasty in intertrochanteric fracture femur

Intertrochanteric femur fractures are becoming more common in the aged population, accounting for 45 percent of all hip fractures and being the leading cause of morbidity and mortality in the elderly. According to several classifications, intertrochanteric fractures of the femur can be split into two groups: stable intertrochanteric fractures and unstable intertrochanteric fractures. In addition to instability, osteoporosis and commination can develop in the elderly population. The goal of treatment of any intertrochanteric fracture of femur in elderly is to make patient mobile early and reducing associated complications of prolonged immobilization. Rapid mobilization of these elderly patients results in decreased morbidity and mortality. In earlier time, treatment of intertrochanteric fracture was mainly conservative in the form of prolonged bed rest in sustained traction for minimum of 12 weeks,but due to prolonged immobilization in bed this treatment resulted in complications like bed sores, urinary tract infection, pneumonia, thrombo embolic complications resulting in high morbidity and mortality. Along with these complications there also occurred fracture related complications like malunion of fracture and shortening resulting in difficult ambulation of patient. For these reasons later on treatment of intertrochanteric fracture mainly shifted towards fixation with devices like dynamic hip screw and Juwet nail plates. Stable fractures can be easily treated with osteosynthesis with good results however, the management of unstable intertrochanteric fractures. An elderly patients is a challenge because of difficulty in obtaining anatomical reduction and prolonged time taken for fracture healing resulting in delayed mobilization of patient.