Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly

To promote early full weight-bearing and rapid rehabilitation, 20 elderly patients (average age, 82.2 years) with unstable intertrochanteric hip fractures were treated with a bipolar head-neck replacement. Seventeen patients had the prosthesis inserted as primary fracture management, and three, for salvage of failed internal fixation. The patients were ambulating with unrestricted weight-bearing at an average of 5.5 days after the operation. The bipolar design may permit conversion to a total hip arthroplasty without removal of the femoral component, and may reduce the risk of acetabular cartilage damage. By using the greater trochanter as a landmark for precise placement of the femoral head, correct limb length was restored.