The intrapelvic migration of cervicocephalic lag screws is a rare complication after intertrochanteric fracture synthesis with an intramedullary nail. Only 15 cases of intrapelvic penetration by three different instrument systems have been described in the literature. However, to our knowledge, there is no report of intrapelvic migration of the lag screw with wedge wing designed to increase fixation power using the Dyna locking trochanteric (DLT) nail. We present a case of intrapelvic migration of the lag screw with wedge wing from DLT nail. The patient described herein underwent a two-staged operation of implant removal without intrapelvic approach followed by bipolar hemiarthroplasty. With intrapelvic migration conditions, although it is not uncommon to require an additional intrapelvic approach, this modification can lead to lethal consequences. For this reason, it is recommended to coordinate with the vascular surgery department due to the close proximity of the major vessels.
Femur ; Hemiarthroplasty ; Humans

Purpose: To evaluate clinical and roentgenographic outcomes after bipolar hemiarthroplasty utilizing three different greater trochanteric fragment fixation methods for intertrochanteric fracture repair. Materials and Methods: Forty-six hips (Boyd-Griffin type II: 44, type IV: 2) that had undergone greater trochanteric fragment fixation through bipolar hemiarthroplasty were evaluated at a minimum of 1 year following surgery. The fixation groups were: 1) figure of 8 wiring (18 cases), 2) cerclage wiring (23 cases), and 3) tension band wiring (11 cases). The roentgenographic results were evaluated in terms of fragment migration and wire breakage. The functional results were evaluated according to the hip rating scale of Merle d'Aubigne. Results: The rate of fragment migration was 22.2% in group 1, 52.2% in group 2, and 9.1% in group 3, and there was a statistically significant difference among the groups (p=0.022). The rate of wire breakage was 27.8% in group 1, 13.0% in group 2, and 9.1% in group 3, but there was no statistically significant difference among the groups. According to the Merle d'Aubigne scale, 78.6% of the repairs in group 1, 82.4% of the repairs in group 2, and 88.9% of the repairs in group 3 were rated as excellent, very good, or good. Conclusion: The tension band wiring method is more useful than the figure of 8 and cerclage wiring methods for fixing the greater trochanteric fragment during bipolar hemiarthroplasty.
Femur ; Hemiarthroplasty ; Hip

No abstract available.
Aged* ; Femur Neck* ; Hemiarthroplasty* ; Humans

No abstract available.
Hemiarthroplasty* ; Hemorrhage* ; Hip* ; Hypotension* ; Retrospective Studies*

PURPOSE: We classified fractures of the greater trochanter (GT) and evaluated fracture fragment stability according to GT type. MATERIALS AND METHODS: A total of 43 patients with an unstable intertrochanteric fracture treated between January 2007 and July 2009 with bipolar hemiarthroplasty were included in this study. GT fractures were classified as type A, B, C, or D and fixed using either cerclage wiring alone, cerclage wiring and non-absorbable suture or a greater trochanteric reattachment (GTR) plate. RESULTS: Type A fractures were fixed using cerclage wiring with non-absorbable suture in two cases, cerclage wiring in six cases and GTR plate in seven cases. Failure occurred in three cases of type A fractures treated with cerclage wiring alone. A total of 11 type B fractures were fixed with cerclage wiring (7), cerclage wiring and non-absorbable suture (3) and GTR plate (1). There was no failure of type B fractures. Type C fractures were fixed using cerclage wiring with non-absorbable suture in one case and GTR plate in three. There was no fixation in three cases. Of 10 type D fractures, six were treated with cerclage wiring and one with GTR plate. Fixation was not performed in three patients. There was no failure in type C and D type fractures. CONCLUSION: Fracture fragment stability differed according to fracture types. Cerclage wiring alone was insufficient to fix type A fractures, so type A fracture required a stronger fixation method.
Arthroplasty* ; Femur* ; Hemiarthroplasty ; Humans ; Methods ; Sutures

PURPOSE: This study examined the effects of trunk control rehabilitation robot training (TCRRT) on the dynamic balance, lower extremity strength, gait ability and pain for bipolar hemiarthroplasty. METHODS: Hemiarthroplasty (n=28) patients participated in this study. The subjects were randomized into two groups: trunk control rehabilitation robot training group and control group. RESULTS: The TCRRT group showed significantly more improvement in the MFRT, MMT, 10MWT, TUG, and VAS compared to that before intervention (p<0.05). In addition, all tests were significantly greater in the experimental group than in the control group. CONCLUSION: These results suggest that TCRRT is feasible and effective for improving the dynamic balance, lower extremity strength, gait ability, and pain efficacy after bipolar hemiarthroplasty.
Gait ; Hemiarthroplasty ; Humans ; Lower Extremity ; Rehabilitation

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

The authors reviewed both the clinical and radiographic results of 36 bipolar hemiarthroplasty using the porous-coated Harris-Galante uncemented femoral stem performed for avascular necrosis in 30 patients from January 1985 to June 1992. The average age was about 45.6 years and the average follow-up was fifty-four months. Clinical results by the Harris evaluation method were excellent in 33 cases, good in 2 cases, and fair in 1 case. The radiographic fixation of the femoral stem at final follow-up was bony ingrowth fixation in 31 cases, fibrous ingrowth fixation in 4 cases, and unstable fixation in 1 case. There was neither medial nor superior migration of the bipolar cup of more than two millimeters.
Follow-Up Studies ; Head* ; Hemiarthroplasty* ; Humans ; Necrosis*

Redislocation of bipolar hemiarthroplasty is not a simple complication. When redislocation of bipolar hemiarthroplasty occurs, open reduction must be considered. Displacement of the polished tapered femoral stem could occur through the unwanted traction force during the reduction of the dislocated cemented hip arthroplasty as a complication. We experienced displacement of the polished tapered femoral stem during closed reduction of a redislocated cemented bipolar hemiarthroplasty. We suggest that preoperative analysis for the cause and status of the dislocation is essential and open reduction should be considered if closed reduction is not thought to be suitable for a polished femoral stem.
Arthroplasty ; Dislocations ; Displacement (Psychology) ; Hemiarthroplasty ; Hip ; Traction

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*