Evaluation of functional outcome of patients with fracture neck of femur treated with Austin Moore prosthesis at government medical college, Thrissur-a prospective study during October 2019 to October 2020

Authors

  • Jyothish Kavungal Department of Orthopaedics, Government Medical college, Thrissur, Kerala, India http://orcid.org/0000-0002-1115-5978
  • Nihal Suresh Department of Orthopaedics, Government Medical college, Thrissur, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20220600

Keywords:

Hemiarthroplasty, Harris hip score

Abstract

Background: Femoral neck fractures commonly affects the elderly population. 90% of femoral neck fractures in the elderly result from simple fall. Elderly age group suffers from innumerable illnesses such as diabetes, hypertension, coronary artery disease, chronic obstructive pulmonary disease, all of which can aggravate following a femoral neck fracture because patient can become completely bedridden. The aim of treating these patients is to make them mobilize as early as possible to achieve his or her pre-fracture functional status. The incidence of femoral neck fractures is increasing dramatically as the mean age of the population increases. Prosthetic replacement allows immediate weight bearing to elderly patients and thus helps to avoid complications of recumbency and inactivity. To study the functional outcome in patients with femoral neck fractures treated with Hemiarthroplasty using Austin Moore prosthesis.

Methods: Prospective study was done among 42 consented patients who sustained neck of femur fractures and were admitted in department of orthopaedics, government medical college, Thrissur, between 01/10/19 to 01/10/20, who were aged above 60 years and presenting within 3 weeks of injury. Patients were followed up at an interval of 6 weeks, 3 months and 6 months functional outcome was analysed by modified Harris hip scoring system.

Results:  Among the 42 subjects, 52.4 % were females and the rest were males. Mean age of the study population was 71.57±7.047 years. Harris hip score at end of 6 months ranged from 35 to 94. 33.3% of hemiarthroplasties had hip score of 91-100 (excellent), 38.1% of the hemiarthroplasties had scores of 81-90 (good), 19% had satisfactory/fair results whereas only 9.5% of hemiarthroplasties fell in poor category with scores below 70.

Conclusions: Hemiarthroplasty with Austin Moore prosthesis is still a good option in elderly patients with femoral neck fractures.

Author Biography

Jyothish Kavungal, Department of Orthopaedics, Government Medical college, Thrissur, Kerala, India

Department of orthopedics

Assistant Professor

References

Blomfeldt R, Torkvist H, Ponzer S, Soderquist A, Tidermark J. Internal Fixation versus hemiarthroplasty for displaced fractures of the femoral neck in elderly patients with severe cognitive impairment. J Bone Joint surg Br. 2005;87(4):523-9.

Harthesis JW. Arthroplasty of hip, chapter 7 in: Campbells operative orthopaedics 11th edition. Mosby. 2008;312-481.

Sandhu HS. Management of Fracture neck of femur. Indian J orthop. 2005;39:130-6.

Saxena PS, Saraf JK. Moore Prosthesis in fracture neck of femur. Indian J Orthop. 1978;12:138-45.

Mukherjee DL, Puri HC. Early hemiarthroplasty for fresh fractures of the neck of the femur in geriatric patients. Indian J Surg. 1986;48:77-80.

Bavadekar AV, Manelkar KR. Hemiarthroplasty of the hip in the treatment of intracapsular fracture neck of the femur state of the art and an appraisal. Clin Orthop India. 1987;1:43-52.

Moore AT. The self-locking metallic hip prosthesis. JBJS. 1957;39A:811-27.

Sikorski JM, Barrington. Internal fixation versus hemiarthroplasty for the displaced sub-capital fracture of femur: A prospective randomized study. J Bone Joint Surg Am. 1981;63B:357-61.

Boyd HB, Salvatore JE. Acute fractures of the femoral neck: Internal fixation or Prosthesis. J Bone Joint Surg Am. 1964;46A:1066-8.

D'Acry J, Devas M. Treatment of fractures of the femoral neck by replacement with the Thompson prosthesis. J Bone Joint Surg Am. 1976;58B:279-86.

Hinchey Day. Primary prosthetic replacement in fresh femoral neck Fractures. J Bone Joint Surg Am. 1960;42B:633-40.

Evarts CM. Endoprosthesis as the primary treatment of femoral neck fractures. Clinc Orthop. 1973;92:69-76.

Seth MK. Stress fractures of the neck of femur. Clin Orthrop India. 1987;1:105-9.

Stinchfield FE, Cooperman B, Shea CE. Replacement of the femoral head by Judet or Austin Moore Prosthesis. JBJS 1957;39A:1043-58.

Klenerman L, Marcuson RW. Intracapsular fractures of the neck of the femur. J Bone Joint Surg Am. 1970;52B:514-7.

Savastano AA, Sage LA, Zecchino V. Treatment of fractures of the neck femur with intramedullary stem prosthesis. Arch Surg. 1957;75(6):156-9.

Wai-Hee Lo, Chen WM, Huang CK, Chen TH, Chiu FY, Chen CM. Bateman bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures. Clin Orthop. 1994;302:75-82.

Salvatti EA, Artz T, Algeitti P, Asins SE. Endoprosthesis in the treatment of femoral neck fractures. Orthop. Clinc N Am. 1974;5:757-7.

Arwade DJ. A review of internal fixation and prosthetic replacement for fresh fractures of the femoral neck. Clini Orthop India. 1987;1:77-82.

Ingalhalikar VT, Kumta S. Fracture neck femur anatomical and biomechanical aspects. Clinc Orthop India. 1987.

Stevens J, Freeman PA, Nordin BEC, Barnett E. The incidence of osteoporosis in patients with femoral neck fractures J Bone Joint Surg Am. 1962;44-B:520-7.

Downloads

Published

2022-02-25

Issue

Section

Original Research Articles