A clinical study on intracapsular fracture neck of femur in elderly treated by hemiarthroplasty

Abstract

Background: Hip fractures are devastating injuries that commonly affect the elderly and have a tremendous impact on the health care system and society in general. This further handicaps the treatment of these fractures and the healing process is always in doubt. A successful operation at the hip joint should provide painless, stable hip with wide range of movements. Earlier hemireplacement arthroplasty is the treatment of choice for displaced femoral neck fractures in the elderly. Materials and Methods: A total of 50 cases of intracapsular fracture neck of femur in elderly patients above the age of 50 years irrespective of sex treated by hemiarthroplasty using unipolar (Austin Moore's / Thompson's) or bipolar endoprosthesis, in the Department of Orthopaedics at Father Muller Medical College and Hospital, Mangalore between August 2015 to January 2017, were included in the study. Results: In our study most of the patients were in the age group of 50 to 70 years with mean average age of 65.33 years for males and 64.73 years for females. Majority of the fractures were subcapital radiologically. Sixty-three percent of the patients had comminution of the posterior cortex of the neck. We used Moore's posterior approach for all the patients and appropriate sized prosthesis were selected depending on the size of the femoral head. Patients were ambulated early. Most of the patients were discharged within two weeks of surgery. Outcomes at 6 weeks, 3 months and 6 months were analysed by modified Harris hip scoring system6 and by radiographs taken during follow up. Conclusion: Hemiarthroplasty by using either unipolar or bipolar prosthesis is a good option in elderly patients with displaced fracture neck of femur. The operative procedure is simple, mortality and morbidity associated with it is less. The complications are less disabling, weight bearing is early, early functional results are satisfactory and second operation is less frequently required.