Day by day road traffic accident in Bangladesh is increasing. Mymensingh-Dhaka highway passes beside the Community Based Medical College Hospital, Bangladesh. We often have to manage a greater number of traumatic patients. In road traffic accident the incidence of fracture shaft of femur is the most common. That's why my study was done to evaluate the result of management of fracture shaft of the femur with antegrade interlocking intramedullary nailing under the department of Orthopedic Surgery in CBMCH,B in the period between January 2009 to July 2013. Total 88 patients were selected for interlocking nailing initially in the study. Out of them 8 patients did not report in subsequent follow up. So the result of the study was based on 80 patients (48 males; 32 females) with the range of 20- 68 years of age. The average age of the patient was 36 years. Motor vehicle accidents was the most common cause of fracture shaft femur (65%) and the second most common cause was fall from height (20%) specially fall from tree. Among the patients; right sided femur involvement was 67.5% (54) and left sided femur involvement was 32.5% (26). The majority fracture of the shaft of the femur was lower third (70%). The patients were mostly in the day-laborers' groups (35%), and, the next group was students. The mean union time was 18 weeks with the range of 15-30 weeks. After operation, complications were found such as; infection 3.75%(3), non-union 1.25% (1). Excellent functional outcome was found in 82.5% (66), good in 12.5% (10), fair in 5%(4). This functional outcome study was evaluated by Klemm & Borner 1 criteria. CBMJ 2015 January: Vol. 04 No. 01 P: 13-17
Back ground: Whether bipolar hemiarthroplasty[BH] for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty[UH] remains controversial. Intracapsular fracture neck femur mainly occur in elderly person. The prime goal of treatment is to return the patient to their pre-fracture functional status. The surgical treatment is the treatment of choice, hip replacement arthroplasty (hemi or total) is a viable choice in treatment option. In this clinical study 96 elderly patients (age 55-78 years) with a displaced intracapsular femoral neck fracture were treatment over a six year period (December 2009 to December 2015). All of them underwent hemiarthroplasty either bipolar or unipolar, after appropriate medical and anesthetic fitness. The patients were reevaluated at two weeks, six weeks, at six months postoperative and assessed using mainly Harris hip score (HHS) and visual analogue scale (vas) for evaluation of clinical and surgical outcome Also x-ray done to seen erosion of acetabulam. The mean age of patients was 64.5 years and male female ratio 45.83% -54.17%. The mean HHS score was 83.5 for BH and 82.5 for UH at the end of the 6 months. The mean score on VAS scale was 4mm (mu) at 6 months for both BH and UH follow up visit. At the one year 03 cases of unipolar complications mild hip pain. No patients need revision surgery. Bipolar and unipolar hemiarthroplasty is the treatment of choice in elderly patient with displaced femoral neck fracture provides early ambulation, good functional outcome, pain free joint with minimal complications without the need for revision surgery. There is no significant differences between Bipolar and Unipolar arthroplasty surgically and clinically. CBMJ 2016 January: Vol. 05 No. 01 P: 27-32
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