ABSTRACT
Introduction: Incidence of displaced fracture neck of femuris high and there is lack of consensus over the definitivetreatment of such fractures as the incidence of complicationsespecially avascular necrosis remains very high. Objective ofthe study was to evaluate the incidence of avasular necrosisand its pattern in displaced fracture neck of femur managedwith osteosynthesisMaterial and methods: This study was a prospective studyconducted in Bone & Joint Hospital, Srinagar from 2003 to2018 on patients with displaced fracture neck of femur. Closereduction was done on traction table using Whitman’s Methodand reduction was confirmed under C Arm and was labelledsatisfactory using Lowell’s S Method and fixation was doneusing 3 Cannulated Screws of 6.5mm.Results: 118 patients {70 males and 48 females} with meanage 42.5 years {range 18 to 55 years} presented late in ourhospital which resulted in a delay in fixation from 24 hrs to7 days post trauma. Patients were followed till 2018 for aminimum period of 10 years.Conclusion: Our study suggest same AVN rates as of otherstudies if fixation is done within a period of one week.
ABSTRACT
Background: The fracture neck of femur is one of the commonest fractures in elderly. With life expectancy increasing with each decade, our society is becoming increasingly an active geriatric society, with significant number of hospitalized and nursing home patients with femoral neck fractures and their sequelae. Selection of the type of prosthesis is very important in hemiarthroplasty as different types are available. Since the last two decades, bipolar replacements of the femoral head have gained popularity for treating femoral neck fractures. Aim & Objective – To assess and analyse the results of management of fracture neck of femur with bipolar hemiarthroplasty. Methods: After obtaining ethical committee approval and informed consent from patient, detailed history of patient was taken with particular emphasize on mode of injury and associated medical illness. On the day of surgery , under anesthesia and patient in lateral position, following strict aseptic precautions, either lateral (Hardinge) or Posterior (Southern-Moore) approach incision made, tissues dissected, joint capsule incised and femoral head extracted with the help of cork screw. Then the appropriate size of prosthesis with cement was seated. The wound was closed meticulously in layers. Knee flexion, isotonic quadriceps exercises were started from 1st or 2nd post op day and patients were mobilized with walker as tolerated. Patients are educated on different position of legs that should be avoided in the postoperative period. Follow up was done after 6 weeks and for further at 3 months, 6 months & 1 year .Result: In our series, at the end of final follow-up, there was no evidence of loosening, radiolucent zones, distal migration or subsidence of prosthesis. The patient with Periprosthetic fracture healed and is weight bearing fully with no pain. One patient who had moderate heterotopic ossification had still has some mild pain occasionally. Conclusion: we conclude that bipolar hemiarthroplasty produces good functional outcomes with minimal complications for displaced intracapsular femoral neck fractures and has several advantages; these results are comparable to the other studies.