ABSTRACT
Introduction: Hip fractures in the elderly have represented a major public health concern. Studies have shown that over 90% of the patients having these fractures are people of more than 50 years. These fractures have been classified according to their anatomical location into the neck of femur fracture, intertrochanteric fracture, and subtrochanteric fracture. The neck of femur fractures is associated with high mortality in the elderly compared to young adults. Surgical treatment is an established gold standard, with the option being osteosynthesis and hip replacement. Hemiarthroplasty is one of the gold-standard treatments chosen for the geriatric age group and has yielded universally acceptable results. Materials and Methods: The study evaluates the clinical, radiological, and functional outcomes of hip hemiarthroplasty in elderly with fracture neck of the femur Data of patients above 60 years who were operated on for fracture neck of the femur by bipolar hemiarthroplasty from May 2018 till December 2021were retrieved from the Medical Records Department of SCL Municipal General Hospital, affiliated to NHL Municipal medical college. The patients fitting the inclusion criteria were selected for the study. The sample size was calculated to be 43. Data were collected from the inpatient files, and then patients were asked to complete the questionnaire form during the final follow- up. All the patients were evaluated clinically and radiologically during the follow-up, and the functional outcome was assessed using the Harris Hip Score. Thirty-five patients had a domestic fall as the mode of injury. The lateral decubitus position of all patients was used during the operation that was performed using the Southern Moore approach. Forty patients received cemented femoral stems; the remaining three received press-fit ones. Results: The average age was calculated to be 71.86 years with the male-to-female ratio of 1: 1.15 with an average follow-up of 12.7 months. Eight patients had acetabular erosion at the end of 1 year. There was no femoral stem malalignment or aseptic loosening at the final follow-up. Nine patients had excellent Harris Hip scores, and five had fair scores. The remaining 29 patients had good Harris hip scores. Bipolar hemiarthroplasty has served us well in the study. Forty-one patients were able to get back to their preinjury functional level. Only one patient reported major pain in the hip at the final follow-up. In this study, there was no incidence of dislocation or revision surgeries. Conclusion: The present study modular bipolar hemiarthroplasty provides better pain relief with early mobilization and a good level of return to daily routine activities with minimal complications.
ABSTRACT
Background : The most common major Paediatric injuries treated by Orthopaedic Surgeons are Femoral Shaft Fractures. Early reduction and hip spica are used to treat young children under five years old, whereas intramedullary interlocking nail is used to treat young teenagers over 15 years old. Objectives : To know prevalence of Femoral Fractures in paediatric age groups, to classify fracture type, mode of injury, course of healing and to evaluate the result of low cost-least invasive Ender抯 Nail Fixation in Paediatric patients in developing country. Materials and Methods : It is prospective study with 15 patients of 6-15 years age group with Femur Diaphyseal Fracture were treated with retrograde Ender抯 Nail in our Orthopaedic Department with minimum 6 months follow up. Fracture location was in the upper third of the femur in four cases (26.66%), mid shaft in nine (60%) and (13.34%) lower third in two. Results : All patients had union within an average of twelve weeks (8 to 16 weeks ). Skin irritation caused by a nail was found in one case. Twelve patients achieved excellent results, while three individuals good results, according to Flynn criteria. Conclusion : Enders nailing is recommended for Femoral Diaphyseal Fracture Fixation because it is safe, simple to apply and economical with a lower rate of complications.