Système orthopédique et musculaire : recherche actuelle
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ISSN: 2161-0533
ISSN: 2161-0533
Kapil Mani KC*, Dirgha Raj RC, Parimal Acharya and Bandhu Ram Pangeni
Background: The management of displaced femoral neck fracture in elderly patients is debated subject for many years. There is high chance of fracture nonunion with internal fixations, significantly increased bone wear both in hemi-arthroplasty (HA) and bipolar arthroplasty ultimately landing into the revision surgery. In recent years total hip arthroplasty (THA) for displaced fracture neck of femur in elderly patients has been considered as a primary treatment because of its excellent functional outcomes, low revision rates and even cost effective.
Materials and Methods: A total of 20 total hip arthroplasty was performed for displaced femoral neck fracture of patients more than 65 years. All the patients were operated through modified Harding’s approach. Both cemented and un-cemented types of arthroplasty were performed. Functional outcomes of hip were evaluated at 3 months and 1 year after surgery.
Results: The Average age of patients was 71.5 year (range 66 to 81 years) with 8 (40%) male, 12 (60%) female. There were 7 (35%) fractures in right side and 13 (65%) in left side. Fifteen percentage of patients have diabetes mellitus, 20% have hypertension, 15% have old cerebro-vascular accident (CVA) and 25% have Ischemic heart disease (IHD). Even though post-operative mortality after 3 month was nil, one year mortality was 5%. Functional outcomes of hip according to Harris Hip Score (HHS) were 85% of excellent and good results and 15% of fair results.
Conclusion: Total hip arthroplasty is a good option for displaced femoral neck fracture for independently mobile, mentally competent, elderly patients of age more than 65 years with better rehabilitation potential, function of hip, and very low revision rate.