Unipolar Versus Bipolar Hemiarthroplasty: Functional Outcome After Femoral Neck Fracture at a Minimum of Thirty-six Months of Follow-up

2002 ◽  
Vol 16 (5) ◽  
pp. 317-322 ◽  
Author(s):  
Bernard C. Ong ◽  
Stephen G. Maurer ◽  
Gina B. Aharonoff ◽  
Joseph D. Zuckerman ◽  
Kenneth J. Koval
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Bipolar Hemiarthroplasty ◽  
Neck Fracture

scholarly journals Cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures

2018 ◽  
Vol 4 (3) ◽  
pp. 519
Author(s):  
Tushar Chaurasia ◽  
Rajat Charan
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Displaced Femoral Neck Fractures ◽  
Uncemented Hemiarthroplasty ◽  
Neck Fracture ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Uncemented Group

<p class="abstract"><strong>Background:</strong> This study compared functional outcome and results between cemented and uncemented bipolar hemiarthroplasty in patients older than 60 years with displaced femoral neck fracture.</p><p class="abstract"><strong>Methods:</strong> Total fifty four patients with displaced femoral neck fracture were enrolled in this study. Out of total twenty eight patients underwent uncemented bipolar hemiarthroplasty and remaining twenty six patients underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patient’s pain and functions were evaluated with visual analogue scale and Harris Hip Score<strong> </strong>and then compared to each other.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in cemented group compared to the uncemented group (p&gt;0.05). The mean pain score was significantly less in the cemented group compared to the uncemented group (p=0.001). Hip functional outcome based on HHS was more in the cemented (p=0.001). The intraoperative and postoperative complication rate was higher in the uncemented group (p&lt;0.05).</p><p><strong>Conclusions:</strong> Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complication and improve patient’s function in less time. </p>

scholarly journals Cemented monoblock hemiarthroplasty: a dependable option in femoral neck fracture in elderly

2019 ◽  
Vol 7 (4) ◽  
pp. 1178
Author(s):  
Santosh Kumar ◽  
Vikas Verma ◽  
Sanjeev Kumar
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Early Mobilization ◽  
Cost Effective ◽  
The Elderly ◽  
Osteoporotic Bone ◽  
Design Modification ◽  
Neck Fracture

Background: Femoral neck fracture in elderly continues to pose a treatment dilemma. Associated co-morbidities and high mortality (1-year mortality of 25–30% and only 25% survivorship at 10 years) often skews the surgical decision. The underlying treatment goal is minimum revision and maximum functional outcome. Lack of clear guidelines is reflected by the continued debates regarding their management namely osteosynthesis vs arthroplasty; hemiarthroplasty vs total hip arthroplasty, unipolar vs bipolar and cemented vs uncemented. A review of joint registries, uniformly suggest that cemented fixation in elderly patient results in early mobilization, less residual pain and the lowest risk of revision. We analyzed clinical outcome of cemented monoblock hemi-arthroplasty (modified design) in femoral neck fracture in elderly.Methods: Total 94 cemented hemiarthroplasty, performed since January 2009, with a minimum follow up of 3 years are included in the study. Mean modified Haris Hip score at 2 years, 3 years and in the last follow up was 88 (72-91), 84 (70-89) and 81 (65-86) respectively. Acetabular erosion was noted in three patients (3.19%) (one was symptomatic) and aseptic loosening in another two patients (2.12%). Major complications such as deep wound infection, dislocation or peri-prosthetic fracture were not noted in any patient.Results: Result of the present study is consistent to marginally superior when compared to cemented Thompson monoblock and the cemented bipolar prostheses. We attribute this to routine use of cement in the elderly osteoporotic bone along with design modification of the monoblock stem. Long term result of THA is marginally (not statistically significant) better compared to hemiarthroplasty. However, it is associated with prolonged surgery, more blood loss and higher dislocation rate. The rates of dislocation following THA, bipolar and unipolar arthroplasty were 11%, 3%, and 2% respectively.Conclusions: Cemented monoblock hemiarthroplasty is effective and viable option in displaced femoral neck fracture in elderly in terms of excellent functional outcome, low reoperation without adversely affecting morbidity and mortality. Being cost effective procedure this may be considered as first line surgical option especially in socio-economically disadvantaged section of the society.

Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

2008 ◽  
Vol 149 (11) ◽  
pp. 493-503 ◽  
Author(s):  
Andor Sebestyén ◽  
Imre Boncz ◽  
Ferenc Tóth ◽  
Márta Péntek ◽  
József Nyárády ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

scholarly journals A Case Report of Femoral Neck Fracture in an Elderly Patient Managed by Non-operative Korean Medical Treatment : 42 Months Follow-up

2018 ◽  
Vol 35 (4) ◽  
pp. 252-258 ◽  
Author(s):  
Ju-ran Kim ◽  
Han Mi Gong ◽  
Seungah Jun ◽  
Jung Hee Lee ◽  
Bong Hyo Lee ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Femoral Neck ◽  
Medical Treatment ◽  
Femoral Neck Fracture ◽  
Neck Fracture

scholarly journals Calcar buttressed screw fixation for femoral neck fracture

2018 ◽  
Vol 5 (1) ◽  
pp. 145
Author(s):  
K. K. Arvind Manoj ◽  
R. Karthik ◽  
A. Vishnu Sankar
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Screw Fixation ◽  
Femoral Neck Fractures ◽  
Fixation Strength ◽  
Harris Hip Score ◽  
Average Period ◽  
Excellent Outcome ◽  
Neck Fracture

<p class="abstract"><strong>Background:</strong> The incidence of neck of femur fracture among elderly population is increasing day by day. Femoral neck fracture has always been an unsolved fracture<strong> </strong>as far as treatment and results are concerned. There are different views regarding the optimal method of internal fixation in femoral neck fractures. Biomechanical data from literature suggest that calcar fixation is superior to central screws placement. This study aims to analyse the functional and radiological outcome of femoral neck fractures treated by calcar buttressed screw fixation described by Filipov as biplane double supported screw fixation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from May 2015 to May 2018.The study included 43 patients (31 male, 12 female) with femoral neck fracture. Three 6.5-mm cannulated screws were laid in two medially diverging oblique planes. The distal and the middle screws were supported on the calcar. The distal screw had additional support on the posterior neck cortex. Patients were followed up for average period of 2 years. Functional outcome was evaluated using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Bone union occurred in 40 patients (93%) with average period of 3-4 months.<strong> </strong>51.2% of cases had<strong> </strong>excellent outcome. 23.2% of cases had good and 16.3% of cases had fair outcome. 9.3% of cases ended with poor outcome. Non union was reported in 3 patients (7%) and AVN in one patient. Various factors like age, Garden and Pauwel fracture types, time of presentation and time of surgery were statistically significant to the final functional outcome in our study.</p><p><strong>Conclusions:</strong> By providing additional calcar buttress compared to conventional method, this technique of screw fixation enhances femoral neck fracture fixation strength and reduces the fixation failure. </p>

scholarly journals Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

2021 ◽  
Vol 15 (5) ◽  
pp. 988-991
Author(s):  
Zamir Hussain Tunioi ◽  
Rizwan Ali Jhatiyal ◽  
M Azeem Akhund ◽  
M Kashif Abbasi ◽  
L Das Maheshwari ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Cross Sectional ◽  
Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

Comparative Analysis of Preoperative and Postoperative Muscle Around Hip Joint by Computed Tomography Between Intertrochanteric Fracture and Femur Neck Fracture

2020 ◽  
Author(s):  
Sung Yoon Jung ◽  
Hyeon Jun Kim ◽  
Kyu Taek Oh
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Intertrochanteric Fracture ◽  
Femoral Neck Fractures ◽  
Final Visit ◽  
Cross Sectional ◽  
Fracture Group ◽  
Significant Difference ◽  
Neck Fracture

Abstract Background:This study assessed the changes in hip muscles by comparing the preoperative and postoperative CT scan results between patients with intertrochanteric versus femoral neck fractures. Methods:48 patients who received surgical treatment for intertrochanteric or femoral neck fractures from February 2013 to February 2019 and underwent pelvic computed tomography(CT) preoperative and postoperatively aged 65 and older with a minimum follow-up of 1 year were included. The subjects were divided into two groups: 26 patients with intertrochanteric fracture and 22 patients with femoral neck fracture. We measured the cross-sectional area(CSA) and attenuation of the gluteus medius(G.med), gluteus minimus(G.min), iliopsoas(IP), and rectus femoris(RF) on the contralateral side. Patient basic data were collected from medial records including sex, age, height, weight, BMI, BMD, Harris hip score (HHS), and length of follow-up until the final visit. Results: There was no significant difference in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up until the final visit between two groups. The femoral neck fracture group had significantly larger CSA and cross-sectional area per weight(CSA/Wt) of the G.med and G.min(G.med CSA, CSA/wt preoperative 1995.29 vs 1713.64, 38.87 vs 32.74; postoperative 2144.98 vs 1815.56, 37.48 vs 32.78/G.min preoperative 745.22 vs 566.59, 14.32 vs 10.96; postoperative 764.39 vs 619.17, 14.78 vs 11.25). On the contrary, the intertrochanteric fracture group had significantly greater CSA and CSA/Wt of the IP and RF(IP preoperative 810.86 vs 661.88, 17.73 vs 9.42; postoperative 681.98 vs 571.32, 12.68 vs 9.88/RF preoperative 503.66 vs 386.72, 9.42 vs 7.23; postoperative 426.24 vs 349.31, 7.17 vs 5.23). HHS related with function had no significant correlation with postoperative CSA and CSA/Wt. There was no significant difference in attenuation between two groups. All subjects had a significant decrease of muscle attenuation postoperatively.Conclusions: The CSA of the hip abductor(G.med and G.min) was significantly larger in the femoral neck fracture group, while the CSA of the hip flexor(IP and RF) was significantly higher in the intertrochanteric fracture group. Based on these findings, choosing the rehabilitation program suitable for the fracture site is expected to be beneficial in hip fracture rehabilitation.

scholarly journals Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients

2019 ◽  
Vol 8 (8) ◽  
pp. 1149 ◽  
Author(s):  
Kwon ◽  
Lim ◽  
Yang ◽  
Lee ◽  
Jeon ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Femoral Neck ◽  
Renal Impairment ◽  
Femoral Neck Fracture ◽  
Bipolar Hemiarthroplasty ◽  
Neck Fracture ◽  
Group 3 ◽  
Group 2 ◽  
Complications And Mortality ◽  
Group 1

Background: The aim of this study was to investigate the relationship between estimated glomerular filtration rate (eGFR) and outcomes of bipolar hemiarthroplasty for femoral neck fracture in elderly patients, and to compare postoperative complications and mortality among groups according to eGFR. Methods: A total of 181 patients who underwent bipolar hemiarthroplasty for displaced femoral neck fracture were divided into three groups according to eGFR. Data were retrospectively analyzed. Group 1 had 96 patients with eGFR greater than or equal to 60 mL/min/1.73 m2; Group 2 had 54 patients with eGFR greater than or equal to 30 mL/min/1.73 m2 and lower than 60 mL/min/1.73 m2; and Group 3 had 31 patients with eGFR lower than 30 mL/min/1.73 m2. Postoperative complications and mortality were compared between groups at a minimum 2-year follow-up. Results: Patients in Group 3 had the longest hospital stay of the three groups (p = 0.001). The rates of medical complications did not differ significantly among groups. However, Group 2 and 3 had higher rates of surgical complications (p = 0.001) and mortality (p = 0.043) than Group 1. Severe renal impairment was associated with increased risk of postoperative complications compared to mild renal impairment (odds ratio (95% confidence interval) = 4.33 (1.32–13.19), p = 0.015). Conclusion: Patients with moderate or severe decreased eGFR associated with chronic kidney disease (CKD) could have higher postoperative complications and mortality after bipolar hemiarthroplasty compared to patients with CKD stage 1 or 2.

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