Internal fixation versus hemiarthroplasty for displaced femoral neck fractures in the elderly | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 47, Issue 3, September 2012, Pages 311-314 PDF (417.01 K) | ||
| DOI: 10.7123/01.EOJ.0000417982.94357.74 | ||
| Author | ||
| Tamer Ahmed EL-Sobky | ||
| Abstract | ||
| Introduction Femoral neck fractures are among the most common orthopaedic injuries in patients older than 60 years. To date, there is no clear consensus about which patients are best treated by internal fixation and which by some form of arthroplasty. Patients and methods We conducted a prospective, randomized clinical study to compare the results of bipolar hemiarthroplasty with those of internal fixation for displaced intracapsular femoral neck fractures in elderly patients. Forty patients were included. Twenty patients were operated upon using bipolar hemiarthroplasty. Another 20 patients were operated upon using closed reduction and internal fixation using three cancellous screws. Their ages ranged from 50 to 70 years. The follow-up period ranged from 17 to 30 months, with a mean duration of 23 months. Patients were evaluated clinically by means of self-reported Harris Hip Scores. Results The mean postoperative self-reported Harris Hip Score for the hemiarthroplasty group was higher than that for the internal fixation group. The difference was statistically significant. In the hemiarthroplasty group, reoperation rate was 15% (three patients), with no cases of prosthetic dislocation. In the internal fixation group, one patient was lost to follow-up and five patients developed avascular necrosis (AVN) (26.3%). Four patients (21%) developed nonunion. The reoperation rate was 52.6% (10 patients). The amount of transfused blood units was greater and the operative time was significantly increased in the hemiarthroplasty group. Conclusion In conclusion, hemiarthroplsty after displaced femoral neck fractures in the elderly is better in terms of functional outcome, pain relief and revision rates, compared with internal fixation. However, hemiarthroplasty may be associated with an increased trend towards postoperative infection. | ||
| Keywords | ||
| Hemiarthroplasty; internal fixation; neck femoral | ||
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