A study of intracapsular fracture neck femur treated with bipolar prosthesis
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 8894-8902
AbstractBackground and Objectives: Fractures of the neck of the femur occur predominantly in the elderly, typically result from low energy falls and may be associated with osteoporosis. Most fractures of the femoral neck are intracapsular. The incidence of femoral neck fractures is set to double over the next 30 years; this is the reflection of a higher number of individuals living beyond 65 years. Presently, there are multiple surgical treatment options available. Open reduction and internal fixation of these fractures in elderly has poor outcome due to high rate of non - union and avascular necrosis. With unipolar hemiarthroplasty the problems encountered were acetabular erosion and loosening of stem giving rise to pain. The main aim is to reduce immobilization and make patient walk early. The unipolar prosthesis is being slowly replaced by bipolar prosthesis. The objective of this study was to know the functional outcome of intracapsular fracture neck femur with bipolar prosthesis and to study the associated complications in these cases.
Materials and Methods: The present study was prospective study of 35 cases of fracture neck of femur admitted in Khaja Banda Nawaz Teaching and General Hospital, Kalaburagi, between the study period from November 2015 to October 2017. Cases were selected according to inclusion and exclusion criteria. Written informed consent was taken after appropriate medical and anesthetic fitness. Cemented modular bipolar prosthesis was used in all the patients and the functional analysis was performed at regular intervals.
Results: The average age of the patients in this study was 71.6 yrs, 12 (34.28%) were males and 23 (65.71%) were females. Final analysis of the Harris hip score was done after completion of one year. 32 (91.43%) patients had none to slight pain, 31 (88.57%) patients had none to mild limp, 29 (82.59%) patients used none to single cane for long walks, 30 (85.71%) patients could walk unlimited to more than 500 meters. There was no fixed deformity in our patients. In our study, 32 (91.43%) patients had range of motion between 161-300 degrees. The final Harris Hip Score ranged from 59 to 97 with an average of 82.17. 9 (25.7%) of the patients had an excellent Harris Hip Score, 15 (42.9%) had good score, 7 (20%) had fair score and 4 (11.4%) had poor score. There were no significant radiological abnormalities.
Conclusion: Bipolar hemiarthroplasty provides better range of motions, good relief of pain and good level of activities with minimal complications. We conclude that bipolar hemiarthroplasty is a good method to manage intracapsular fracture neck of femur in elderly patients.
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