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Indian Journal of Orthopaedics Surgery


Management of fracture neck of femur in elderly by hemiarthroplasty: A study


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Author Details: Maruthi CV, Shivanna

Volume : 2

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 170

Article End Page : 180


Abstract

Background and Objectives: This is a prospective study of fifty cases of intracapsular fracture neck of femur in elderly patients above the age of 60 years irrespective of sex which were treated by hemiarthroplasty using Austin moore’s/ bipolar endoprosthesis, in the Department of Orthopedics at our institute. Patients were followed up and functional results were analyzed with the objectives to study the age and sex incidence of fracture neck of femur, quality of life after hemiarthroplasty, morbidity and mortality associated with the procedure, recovery of physical, social and occupational independence.
Methods: Fifty cases of fracture neck of femur in elderly patients above the age of 60 years were treated by hemiarthroplasty using either Austin Moore’s, or bipolar prosthesis in the Department of Orthopedics from November 2008 to November 2013. The cases were followed up for 6 months and the short term functional results were analyzed by using modified Harris hip scoring system.
Results: The patients who had fracture neck of femur and who underwent hemiarthroplasty were in the age group of 60 to 98 years with mean average age of 69.82 years. Females were predominant. Majority of the fractures were sub-capital by radiological diagnosis. In 78 percent cases the mode of injury was trivial trauma. Hypertension, diabetes mellitus and chronic obstructive pulmonary disease were the common associated medical conditions. The post-operative complications observed were bedsore, periprosthetic fracture and posterior prosthetic dislocation. A six month follow up was done. One patient expired and four cases were lost for follow up. Thus the functional results were analyzed in the remaining 45 cases. There were 22.2% excellent results and 40% good results. Results of Austin Moore and bipolar prosthesis were not compared as the data and time period of the study was not enough to reach a statistical significance.
Interpretation and Conclusion: The success of hemiarthroplasty depends on preoperative planning and proper attention to surgical details to achieve the optimum biomechanical stability. The poor results (15.56%) were due to moderate to marked pain in the hip or thigh after hemiarthroplasty. We conclude that hemiarthroplasty for fracture neck of femur is a good option in elderly patients. The morbidity and mortality are minimal, complications are less disabling and early functional results are satisfactory.

Key Words:
Hemiarthroplasty, Femoral neck fracture, Austin Moore’s, Bipolar, Short term