Journal of Orthopaedic Case Reports · Nov 2026

Functional Outcomes of Primary Cemented Bipolar Hemiarthroplasty for Comminuted Intertrochanteric Femur Fractures in Elderly Patients: A Prospective Study

By Kumar ASK, Vamshi BS, Chickle B

INTRODUCTION: Intertrochanteric fractures are among the most common fragility fractures in the elderly, and comminuted, unstable patterns are difficult to manage with fixation alone because of poor bone stock and loss of posteromedial support. While intramedullary devices, such as the proximal femoral nail remain the standard of care, primary hemiarthroplasty has been proposed as an alternative when early weight-bearing is a priority, though supporting evidence remains limited. This study evaluated the clinical and functional outcomes of primary cemented bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Orthopaedics of a tertiary-care teaching hospital over 18 months (May 2023-February 2025), with post-operative follow-up to 6 months. Thirty patients aged 60 years or older with Boyd and Griffin type II or III intertrochanteric fractures underwent primary cemented bipolar hemiarthroplasty through a posterolateral approach. Functional outcome was assessed using the Harris Hip Score, alongside operative parameters, complications, limb shortening, and time to full weight-bearing. RESULT: The mean age was 69.88 years ± 6.38 years (15 males, 15 females). Mean operative time was 84.07 ± 10.26 min, and mean estimated blood loss was 287.67 ± 110.63 mL; 46.7% of patients required transfusion. Post-operative complications occurred in 20% of patients, most commonly abductor weakness (16.7%). Mean limb shortening was 0.98 ± 0.58 cm, and mean time to full weight-bearing was 6.21 ± 1.47 days. At final assessment, 13.3% of patients had excellent, 30% good, 36.7% fair, and 6.7% poor Harris Hip Scores; 13.3% died during follow-up. Greater blood loss and transfusion requirement were significantly associated with post-operative complications (P = 0.028 and P = 0.046, respectively). CONCLUSION: Primary cemented bipolar hemiarthroplasty allowed early weight-bearing and produced predominantly fair-to-good functional outcomes in these selected elderly cohort with comminuted intertrochanteric fractures, with an acceptable complication profile. Given the small sample size and absence of a comparison group, these findings support the feasibility of hemiarthroplasty in this setting rather than its superiority over internal fixation.

doi.org/10.13107/jocr.2026.v16.i11.8532Open accessPubMed 42996993Interventions