Total hip arthroplasty following failed primary surgery of fracture neck femur

ABSTRACT

Reporting the problems and early results of total hip arthroplasty following primary surgery of fracture neck femur whether it was by open reduction and internal fixation or hemi-arthroplasty . Sixty Jive cases with failed primary surgery of fracture neck femur 26 cases with ORIF. 19 cases with Austin Moore prosthesis . 17 cases with Thompson prosthesis . 3 cases with Bipolar arthroplasty. Hardinge approach was used in all cases . Bone defects were evaluated and filled with bone graft if needed. The total hip prosthesis was then inserted. The approach used did not affect the duration of operation . Extraction of the prosthesis was difficult in 6 cases and this only was encountered in Thompson prosthesis [5 cases and Bipolar prosthesis [one case] . Cracks of the shaft of the femur occurred in 5 cases of patients with cemented prosthesis during cement removal but no evident fractures happened . Early wound complications were seen in one case after ORIF, and 2 cases of hemiarthroplasty . Early postoperative dislocation of the prosthesis were not encountered in any case . One case encountered 3 months post operatively . Harris Hip Score at the final follow up showed a mean 80.1 . At the end of follow up ; 38 cases [58.4%] had an excellent results . 15 cases [23.1%] had a good results . 7 cases [10.8%] had a fair results . 5 cases [7.7%] had a poor results: