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Functional outcome of intracapsular neck of femur fractures with bipolar hemiarthroplasty v/s total hip arthroplasty in patients between 50 to 80 years of age

Author: 
Dr. Mishil Parikh, Dr. Amit Dhond and Dr. Sunirmal Mukherjee
Subject Area: 
Health Sciences
Abstract: 

Background: Intracapsular fracture of the neck of femur is one of the commonest fracture an Orthopaedic Surgeon encounters in the emergency room. Patients from all age groups can present with this fracture.Osteosynthesis is the preferred and considered a reliable method of treatment for an intracapsular fracture in young patients. A Hemiarthroplasty is preferred for elderly (>60 yrs) patients with these fractures, especially with those who have low functional demands. A Total Hip Arthroplasty is performed for those with associated with acetabular degenerative changes. However, there exists a controversy between Hemi or Total Hip Replacement as the choice of surgery in patients with displaced intracapsular neck of femur fractures in relatively young and active adults as well as elders without significant acetabular degenerative changes Materials and Methods: 30 patients with displaced intracapsular femur neck fractures were treated with a Bipolar hemiarthroplasty (n=16) and a Total hip arthroplasty (n=14) from June 2011 to January 2014. They were followed up weekly for 4 weeks, monthly for 3 months and then 3 monthly till the end of the study. The functional outcome was assessed with the use of the Harris Hip Score. Results: The mean age of the patients was 57.65 years. The mean follow-up in Group 1 was 10.17 months while that in Group 2 was 9.7 months. The mean blood loss was higher in Group 2 [543.75ml] as against Group 1[445.24ml] (p= 0.004). The Harris Hip Score at the end of 6 months was Excellent for 2 patients, Good for 9 patients, Fair for 3 patients and Poor for 2 patients in Group 1 and was Excellent for 4 patients, Good for 8 patients, Fair for 2 patients and Poor for 0 patients in Group 2. 27 patients were able to do all their daily activities and 3 were unable to do so owing to their general medical condition. Conclusion: Total Hip Arthroplasty offers better functional outcome in early follow-up and can be used for treating for these fractures in this age group.

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