ABSTRACT
Introduction: Problems of the hip joint, whether due to trauma or arthritis need surgical skill and judgement often requiring multiple surgical procedures and prolonged rehabilitation. Bipolar hip replacement offers a durable and versatile solution for many problems of the hip in which replacement of the head and neck of the femur in a hemiarthroplasty offers advantages of rapid return to function with a pain free hip. Replacements cannot last forever and this becomes a concern particularly in relatively younger individuals. Aim of the study: To evaluate the efficacy of Biploar hip prosthesis, in management of intracapsular fracture neck femur in physiologically younger patients where replacement of the head and neck of the femur offers the advantage of rapid return of joint function. Materials and Methods: This was a prospective study done in the department of Orthopedics, Government General Hospital, Kurnool, where 30 patients with intracapsular fracture neck femur underwent bipolar prosthesis procedure. Post-operative clinical and radiological follow up was done at 6 weeks, 3 months, 6 months and 1 year. The outcome was graded as poor, fair, good and excellent. Complications were looked for. Results: Good to excellent results were seen in 96% of the patients. Infection was seen in 4% of cases. None of the cases had dislocation or loosening of prosthesis. No mortality or major complications, revision surgery or mortality were seen.
ABSTRACT
Introducción: Las fracturas de cadera son muy frecuentes en ancianos. La hemiartroplastia es un tratamiento aceptado para las fracturas mediales desplazadas en pacientes ancianos y con baja demanda funcional. El objetivo de este trabajo es documentar la tasa de mortalidad a los 30 días y al año, y las complicaciones asociadas en pacientes con mal estado general. Materiales y Métodos: Desde 2003 hasta 2010, se operaron 1134 pacientes con diagnóstico de fractura medial de cadera. El 9% (101) fue tratado con hemiprótesis de Austin Moore, y 91 de ellos fueron incluidos en esta serie. Todos eran deambuladores intradomiciliarios y tenían múltiples comorbilidades asociadas. La supervivencia fue evaluada con el método de Kaplan-Meier; y la asociación entre mortalidad y sexo, infección y luxación, con un modelo de regresión de riesgos proporcionales de Cox. Resultados: Setenta pacientes eran mujeres (77 %) y la media de la edad era de 85 años. La mortalidad fue del 7 % a los 30 días y del 36 % al año. Diez pacientes (11 %) presentaron algún episodio de luxación protésica y 13 (14,3 %) sufrieron una complicación infecciosa. La asociación entre infección/mortalidad y sexo masculino/mortalidad fue estadísticamente significativa (p = 0,009 y p = 0,013). Los pacientes con infección tuvieron una tasa más alta de luxación (p = 0,00001). Conclusión: La hemiartroplastia con prótesis de Austin Moore es una alternativa válida para pacientes con fractura medial desplazada, baja demanda funcional y mal estado general, pues es un procedimiento rápido, que elimina el dolor, y permite una movilidad precoz...
Background: Hip fractures are common in elderly people. Hemiarthroplasty is an accepted treatment for intracapsular fractures of the hip in elderly patients with low functional demands. The objective of this study is to show the 30-day and 1-year mortality rates and associated complications in patients with bad performance status. Methods: Between 2003 and 2010, 1,134 patients with intracapsular fractures of the hip were treated. One hundred and one patients (9 %) were treated with Austin Moore hemiprosthesis and 91 of them were included in this series. All were toddlers in their homes and they had multiple comorbidities. Kaplan-Meier estimator was used to evaluate survival. Mortality was then related to sex, age, infection and dislocation using a Cox proportional hazards regression model. Results: Seventy patients were women (77 %) and the mean age of the series was 85 years. The 30-day and 1-year mortality rates were 7 % and 36 %, respectively. Ten patients (11 %) had an episode of prosthetic dislocation and 13 (14.3 %) had an infectious complication. Infection/mortality and male/mortality associations were statistically significant (p = 0.009 and p = 0.013). Patients who suffered an infection had a higher rate of dislocation (p = 0.00001). Conclusion: Hemiarthroplasty with Austin Moore prosthesis is a good option for patients with displaced intracapsular hip fractures, low activity demand and multiple comorbidities, since it is a quick procedure that eliminates pain, allowing early mobility...
Subject(s)
Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/methods , Femoral Neck Fractures/surgery , Femoral Neck Fractures/mortality , Hemiarthroplasty/methods , Hip Dislocation/diagnosis , Prosthesis Failure , Prosthesis-Related Infections , Follow-Up Studies , Mortality , Postoperative Complications , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the difference between dynamic hip screw and cannulated screw for stability, complication and patient s functional recovery in intracapsular fracture of femoral neck. MATERIALS AND METHODS: Eight-four patients were randomly assigned into dynamic hip screw fixation and cannulated screw fixation groups. Clinical information included age and sex distribution, operation time, total blood loss, interval from injury to operation, etiology of fracture, associated fracture, and functional outcome. Preoperative X-ray information included fracture type by Garden stage, Singh index, and posterior comminution. Postoperative information included quality of reduction, pin and screw position, Garden alignment index, evidence of union, complication and failure. RESULTS: No difference was noted between the two fixation methods regarding gender, initial fracture displacement, postoperative reduction or position of the fixation device, functional outcome using Robinson's method, and complication. In operation time and total blood loss, however, cannulated screw fixation group was significantly lower (P<0.05). CONCLUSIONS: Therefore, to decrease operation time and blood loss, cannulated screw fixation was considered to be more useful as a fixation method in a intracapsular fracture of femoral neck.