DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175066

The role of primary cemented total hip arthroplasty in the management of fractures of the neck of femur in the elderly population

Yeshwanth Subash, Jagadeesh B., Ravikrishna R., Prabhu Manickam

Abstract


Background: Femoral neck fractures are common injuries in the elderly population and are associated with high rates of morbidity and mortality. The aim of surgical intervention in these elderly patients is to restore them to the pre-fracture status as rapidly as possible. The aim of this study was to evaluate the role of total hip arthroplasty as a primary option in the management of these fractures and to compare the results with studies of other authors as available in literature.

Methods: 45 patients with femoral neck fractures treated with cemented total hip arthroplasty were studied from January 2011 to January 2013 and were followed up for a minimum period of two years.

Results: There were 18 males and 27 females ranging from 60 to 75 years of age. Mean age was 64.6 years. Majority (80%) of the fractures were completely displaced, Garden type 4 fractures followed by type 3 in 20% of cases. The most common mode of injury was a simple slip and fall. Excellent results were seen in 17 patients, good results in 24 patients and fair results in 4 patients. No poor results were seen.

Conclusions: Cemented total hip arthroplasty is a very useful procedure for the primary treatment of femoral neck fractures in elderly patients. This procedure markedly improves the functional status of the patients and gives good functional results.


Keywords


Neck of femur, Gardens type, Total hip, Harris score

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References


Alffram PA. An epidemiological study of cervical and trochanteric fractures of the femur in an urban population. Acta Orthop Scand. 1964;65:1-109.

Hopley C, Stengel D, Ekkernkamp A, Wich M. Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ. 2010;340:2332.

Barnes R, Brown JT, Garden RS, Nicoll EA. Subcapital fractures of the femur. J Bone Joint Surg. 1976;58:2–24.

D’Arey J and Devas M. Treatment of fracture of femoral neck by replacement with Thompson’s prosthesis. J Bone Joint Surg. 1975;58:279–86.

Jhonson JTH and Crothers O. Nailing versus prosthesis for femoral neck fractures. J Bone Joint Surg. 1975;57:686.

Riska EB. Prosthetic replacement in the treatment of subcapital fractures of femur. Acta Orthop Scand. 1971;42:281.

Siroski JM, Barrington R. Internal fixation versus hemi- arthroplasty for the displaced subcapital fracture of femur. A prospective study J Bone Joint Surg. 1981;63:357–61.

Michael Saleh, George Murdoch. In defence of gait analysis. J Bone Joint Surg. 1985;67:237–41.

Barnes R. Problems in the treatment of femoral neck fractures. Proc R Soc Med. 1970;63(11):1119-20.

Hodgkinson JP, Shelly P and Wrobeuzki BM. The correlation between radiographic findings at the bone cement function of the socket in Charnley low friction arthroplasties. Clin Orthop. 1988: 228.

Booker AF, Boweman JVV, Robinson RA. Ectopic ossification following THR incidence and method of classification. J Bone Joint Surg. 1973;55:16-29.

Coates RL, Armour P. Treatment of subcapital femoral fracture by primary total hip replacement- Injury. 1979;11(2):132-5.

Delamarter R, Moreland JR. Treatment of acute femoral neck fracture with total hip arthroplasty. Clin Orthop. 1987;218:68-74.

Bryan CS, Morgan SL, Caton RJ, Lunceford EM. Cefazolin versus Cefamandole for prophylaxis during total hip arthroplasty. Clin Orthop. 1988;228:117-22.

Nelson CL, Green TG, Porter RA, Warren RD. One day versus seven days of preventive antibiotic therapy in orthopaedic surgery. Clin Orthop. 1983;176:258-63.

Taine WH, Armour PC. Primary hip replacement for displaced subcapital fractures of the femur. J Bone Joint Surg Br. 1985;67(2):214-7.

Gregory RJ, Wood DJ, Stevens J. Treatment of displaced subcapital fractures with total hip replacement. Injury. 1992;23:168-70.

Greenough CG, Jones JJR. Pr THR for displaced subcapital fracture of the femur. J Bone Joint Surg. 1988;70:639-43.

Gebhardt JS, Namstutz HC, Zinar DM, Dorrey FJ. Comparison of the total hip arthroplasty and hemiarthroplasty for the treatment of acute fractures of the femoral neck. Clin Orthop. 1992;282:123-31.

Sin FH, Stauffer RN. Total hip arthroplasty in acute femoral neck fracture Inst. Course Lect. 1980;29:9-16.