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Indian Journal of Orthopaedics Surgery


Treatment of displaced intracapsular neck fractures in active elderly patient: A Prospective overview of Osteosynthesis versus Prosthesis in 46 patients


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Author Details: Satyendra Phuljhele, Rajendra Kumar Ahire, Harshal Sakale

Volume : 1

Issue : 4

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 241

Article End Page : 250


Abstract

Introduction: This paper determines if Osteosynthesis or Prosthesis replacement should be the treatment of choice, in active elderly patient with unstable intracapsular neck femur fracture.
Material and Methods: A prospective analysis of the results of 46 patients that were performed in Pt. J.N.M. Medical College and associated Dr. B.R.A.M. Hospital Raipur (C.G.) over a period of 2 year was undertaken. The minimum period of follow-up was 2 years.
Results: Out of these 46, 31 patients were treated with internal fixation (Richard’s compressive hip screw with supplementary cancellous screw fixation) and 15 patients were treated with Hemiarthroplasty (Austin Moore Unipolar Endoprosthesis). Overall, the average age of patients was 62.5 years. The mean age for internal fixation was 59 years and that of Hemiarthroplasty was 66 years. 61% of the patients were between 55-65 years of age group. Overall 29 patient (63%) were male and 17 patient were female (37%).Union occurred in 89% of cases in internal fixation. Overall, the functional outcome in internal fixation group was satisfactory with excellent/ good result found in 78% of cases, while in Hemiarthroplasty group it was 63%. Osteosynthesis group has less complication rate like pain, infection, fracture of shaft of femur, shortening and mortality than Hemiarthroplasty group.
Conclusion: Osteosynthesis is justified as a primary treatment of intracapsular hip fracture even in displaced type in active elderly patient aged 55-65 years. Prosthesis replacement should be used in cases where neck is absorbed, in failed Osteosynthesis and in Non-union.

Keywords:
Neck femur, Elderly, Osteosynthesis, Prosthesis