Functional Outcome of Bipolar Hemiarthroplasty in Fracture Neck of Femur
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 5
Abstract
Femoral neck fractures occur most commonly in elderly females. They are uncommon in patients under 60 years of age. We undertook this study to assess the functional outcome of cemented and un-cemented bipolar hemiarthroplasty in patients above 50 years of age with intracapsular neck of femur fractures, and to determine the factors affecting the outcome. Thirty patients above 50 years of age, with the mean age of 64 years ( range 52-87) with intra-capsular fracture neck of femur operated between May 2012 to March 2014 were undertaken for the study. They were operated with either cemented or uncemented bipolar hemiarthroplasty. The clinical and radiological follow-up was done for a minimum period of 6 months. The fractures were classified based on Garden’s classification for femoral neck fractures. The results were assessed using Harris hip evaluation – modified (HHE). The factors affecting the outcome of results were assessed based on age, associated co-morbidities and patient’s general condition. Out of 30 patients, 19 were females and 11 were males (ratio 1.7:1) with an average age of s 64 years. 22 patients had associated co-morbidities like diabetes(DM), hypertension(HTN), coronary artery disease(CAD) and chronic kidney disease(CKD). After 6 months of follow-up using HHE, 17 had good results, 7 had excellent results, 4 had fair results and poor results were observed in 2 patients. The mean Harris hip score was 84.2. Patients aged 51-60 years had better results based on Harris hip score with F-ratio (25.919) and p value (0.001) showing significance in this age group. Ambulation was delayed in three patients; two due to overweight with associated co-morbidities and one due to generalized weakness. There was no stem subsidence, acetabular erosion, acetabular protrusion, or heterotopic ossification in any of the patients during the follow-up period. In our study, all the patients had satisfactory functional outcome. There was no significant difference in using cemented or un-cemented bipolar prosthesis. To conclude, bipolar prosthesis is a safe option in treating fracture neck of femur in the elderly with good recovery in-spite of having several co-morbidities. Keywords: Bipolar hemiarthroplasty, Intracapsular fracture neck of femur, Functional outcome.
Authors and Affiliations
Ram Kumar Ponraj, Senthilnathan Arumugam, Prabhakar Ramabadran
Keywords
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