Treatment of Femoral Neck Fractures: Unipolar Versus Bipolar Hemiarthroplasty

Displaced intracapsular femoral neck (AO type 31 B2/3) fractures have various treatments, including internal fixation (IF), unipolar uncemented hemiarthroplasty (HA), bipolar uncemented HA, unipolar cemented HA, bipolar cemented HA, uncemented total hip replacement (THR), and cemented THR. Systematic literature retrieval was performed from the databases to compare them in a network meta-analysis. Forty studies (85 arms) containing 6141 patients were included. Overall, our network meta-analysis rank the orders of 7 procedures in reoperation, mortality, dislocation and infection, which indicates that IF may provide the highest reoperation incidence, unipolar cemented HA may provide the lowest reoperation incidence; uncemented THR contributes the highest dislocation incidence; and bipolar uncemented HA provides the lowest infection incidence. No differences in mortality were observed among the treatments. This conclusion is indirect; higher-quality direct comparisons are required.

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“…The follow-up period varied from 6 to 204 months. Eighteen studies did not report the number lost during follow-up 6,11,22,27,32–37,41–44,50–53 .…”

Section: Resultsmentioning

confidence: 99%

Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials

Zhang

Wang

Huang

et al. 2017

Sci Rep

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“…This observation is different from that was found in many studies comparing unipolar and bipolar prosthesis. In a study by Somashekar, SVK et al [24], which compared the outcome of unipolar with the bipolar prosthesis in geriatric patients the mean Harris hip score in bipolar and unipolar groups was 86.18±12.18 and 79.79±15.55, respectively (p=0.183); range of motion was 210.63±28.39 and 181.58±37(p=0.015) with bipolar and unipolar groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

Austin moore vs bipolar prosthesis in management of intracapsular fracture of neck of femur by hemiarthroplasty

Nathi¹,

Sarma²

2019

Int J Surg Ortho

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Introduction: Fracture neck of femur is one of the widely occurring hip fractures among elderly people in India. They greatly affect the quality of life in patients, and 30% mortality is observed in these fractures. This study was carried out to study the profile of fracture neck of femur presenting to a tertiary care teaching hospital. The study also assessed functional outcome differences between Austin Moore and bipolar hip prosthesis used in hemiarthroplasty. Methods: The present prospective study includes 50 cases of intracapsular fracture neck of femur in elderly patients above the age of 55 years irrespective of sex treated by hemiarthroplasty using unipolar (Austin Moore's) or bipolar(nonmodular) endoprosthesis followed up for 6 months. After surgery, all the cases were followed up. The functional results after hemiarthroplasty were analyzed using Harris Hip Score (HHS). Results: The mean age was 63.14±5.66 in AMP, and it was 63.29±4 in bipolar prosthesis. The other baseline parameters were comparable between the groups. The mean Harris hip score was 83.19±10.94 in AMP, and it was 84.62±9.53 in bipolar prosthesis. The difference was statistically not significant (P value 0.654). A higher percentage of patients, about 43% were found to have good functional outcome with bipolar prosthesis than those with Austin Moore prosthesis whose percentage having fair outcome was found to be 19%. However, no significant difference was seen between the groups. Conclusion: Treatment outcomes were similar between the two groups.

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“…We previously showed that GARDEN type IV fractures are completely displaced and there is no contact between the femoral head and the femoral neck (49). Studies have shown that with bipolar hip hemiarthroplasty, the management of displaced femoral neck fractures was associated with a better mean score and the incidence of complications was limited (50).…”

Section: Discussionmentioning

confidence: 99%

Fractures of the Proximal End of the Femur: Exploration of Treatments and Assessment of Outcomes

Ioannis,

Eleutheropoulos,

Karanikolas

et al. 2023

ARS Medica Tomitana

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Fractures of the proximal extremity of the femur are some of the most common injuries treated by orthopedic surgeons, often associated with life-threatening polytrauma. Trochanteric fractures have an increased incidence, which is becoming more common due to the aging population. Femoral neck fractures are a particular type of intracapsular hip fracture, and the location of the junction makes the femoral neck prone to fracture. Fractures of the femoral shaft are found in approximately 6-9% of cases of femoral neck fractures. The management of these fractures is interdisciplinary, but in most cases, it requires surgical treatment to allow rapid elevation and recovery of autonomy. The present study is retrospective in which 140 cases of fracture of the upper femur extremity collected at the trauma department of Naousa and Kilkis Hospital over 4 years from December 2018 to December 2022 were analyzed, processed, and reviewed with a minimum follow-up of 6 months. The purpose of this article is to analyze the frequency of various types of fractures of the proximal extremity of the femur and to identify the etiological factors that contribute to these injuries, thus providing a comprehensive understanding of these traumatic events to treat them. The study showed that there is a preponderance of trochanteric fractures, with an increased frequency in the 75-89 age group and a predominance of femoral neck fractures in women, mainly caused by falls. External surgical approaches, standard gamma nail, and bipolar treatment had "excellent/good" functional results reflecting the success of the surgical interventions. The high frequency of anatomical reductions underlines the attention paid to the quality of the procedures.

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Treatment of Femoral Neck Fractures: Unipolar Versus Bipolar Hemiarthroplasty

Cited by 19 publications

References 18 publications

Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials

Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials

Austin moore vs bipolar prosthesis in management of intracapsular fracture of neck of femur by hemiarthroplasty

Fractures of the Proximal End of the Femur: Exploration of Treatments and Assessment of Outcomes

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