CORRELATION BETWEEN HARRIS HIP SCORE (HHS) AND BODY MASS INDEX (BMI) IN PATIENTS WITH FEMORAL NECK FRACTURE AFTER HEMIARTHROPLASTY

2019 ◽  
Vol 7 (1) ◽  
pp. 12
Author(s):  
Muhammad Bayu Z Hutagalung ◽  
Safrizal Rahman ◽  
Azharuddin Azharuddin
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Treatment Options ◽  
Comparative Assessment ◽  
Harris Hip Score ◽  
Cross Sectional ◽  
Intracapsular Hip Fracture ◽  
Neck Fracture ◽  
Cross Sectional Design ◽  
Spearman Test

Femoral neck fracture is an intracapsular hip fracture. Hemiarthroplasty is one of the treatment options that replaces femoral aspect of hip joint with a prosthesis, while leaving the acetabulum intact. The treatment’s goal is to return the patient to premorbid capacity. Harris Hip Score (HHS) is an assessment for the outcome of hip surgery which contains: pain, functional capacity, deformity and range of motion (ROM). The purpose of study is to determine relation of BMI and Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty. This study is analytic-observational study with cross-sectional design conducted in June-September 2014 in Orthopedic’s Polyclinic of General Hospital dr. Zainoel Abidin Banda Aceh. Respondents in this study is 26. Comparative assessment of outcome was analysed by Kruskal-Wallis test with Mann-Whitney test as Post-hoc analysis and correlative assessment was analysed by Spearman test. Comparative assessment present significant relation of BMI (p = 0,006; r=0.458) with Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty.

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>

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.

A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture

2018 ◽  
Vol 100-B (8) ◽  
pp. 1087-1093 ◽  
Author(s):  
B. Barenius ◽  
C. Inngul ◽  
Z. Alagic ◽  
A. Enocson
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Controlled Trial ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Neck Fracture ◽  
Euroqol 5D ◽  
Displaced Fracture

Aims The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58). Results Early differences in functional outcome, assessed using the Harris Hip Score, the Short Musculoskeletal Functional Assessment score and EuroQol-5D, with better results in cemented group, deteriorated over time and there were no statistically significant differences at 48 months. Two (3%) patients in the cemented group and five (6.8%) in the cementless group underwent further surgery for a periprosthetic fracture. This difference was statistically significant (p = 0.4). No patient underwent further surgery for instability or infection between one and four years postoperatively. The mortality and the radiological outcomes were similar in both groups. Conclusion Patients with a displaced femoral neck fracture treated with an arthroplasty using a cemented or cementless stem had good function and few complications up to four years postoperatively. However, due to the poor short-term functional outcomes in the cementless group, the findings do not support their routine use in the treatment of these elderly patients. Cite this article: Bone Joint J 2018;100-B:1087–93.

scholarly journals Imaging observation of percutaneous compression plate use in promoting femoral neck fracture healing

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110335
Author(s):  
Yong Chen ◽  
Haifeng Li ◽  
Liansheng Dai ◽  
Qudong Yin ◽  
Dong Li ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Harris Hip Score ◽  
Secondary Outcome ◽  
Compression Plate ◽  
Neck Fracture ◽  
Percutaneous Compression Plate

Objective To examine the imaging evidence of the use of percutaneous compression plate (PCCP) in promoting femoral neck fracture healing compared with cannulated screws (CS). Methods This retrospective study enrolled patients with femoral neck fractures undergoing internal fixation procedures. The patients were divided into a PCCP group and a CS group with imaging as the primary outcome and Harris hip score (HHS) as the secondary outcome. Results This study included 162 patients: 80 in the PCCP group and 82  in the CS group. There were no significant differences between the patients in their preoperative baseline characteristics. Patient follow-up ranged from 24–56 months (mean 30.7 months). Differences in reduction quality, screw slipping, neck shortening and avascular necrosis (AVN) were not significant between the two groups. There were significant differences between the treatment groups in bone absorption, nonunion, healing time, screw withdrawal and fixation failure in favour of the PCCP group. Postoperative HHS at 6 and 12 months were significantly better for the PCCP group than the CS group, but the differences were not significant at 24 months and last follow-up. Conclusion Stable internal fixation with dynamic compression was the key to PCCP promoting femoral neck fracture healing.

scholarly journals Pauwels screw combined inverted triangle cannulated screws for the treatment of Pauwels type-III femoral neck fracture:- a new surgical method based on the morphology of the fracture

2020 ◽  
Author(s):  
Gang Xue ◽  
Siting Chen ◽  
Maosheng Zhou ◽  
Zhengyu Wang ◽  
Liangliang Wan ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Type Iii ◽  
Operative Duration ◽  
Neck Fracture ◽  
Flexion And Extension

Abstract Background: Femoral neck fracture is a serious injury in adults with significant functional consequences.Internal fixtion is an established treatment for femoral neck fractures in young adult patients .However, the risk of complications following fixation has plague orthopedists for decades.In all femoral neck fracture ,Pauwels type-III femoral neck fractures with a large vertical shear force were more likely to cause clinical failure.The aim of this study is to intruduce a new surgical technique for the treatment of this fracture according to the morphology of the fracture using the combination of Pauwels screw and inverted triangle cannulated screws(PSTCS)，and report the clinical effects in a prospective cohort of 14 patients.Methods: From June 2017 to June 2019, a total of 14 patients (8 males and 6 females ) with Pauwels type-III femoral neck fracture underwent the surgical treatment of PSTCS according to the morphologyical types of fracture in clinical operation in our department. Patients were allowed to perform contraction exercises of quadriceps femoris on postoperative day1, passive flexion and extension exercises postoperative day 2 onwards, and active flexion and extension exercises postoperative day 7 onwards. Patients were allowed for partial-weight bearing walking postoperative 1month onwards with axillary crutches. After one month AP and lateral radiograph were taken. Full ambulation was permitted until the presence of radiological consolidation.Intraoperative (Operative duration,Blood loss),postoperation(Fracture union time,The Harris Hip Score,Visual analog score) were record for comparison.Results: All patients were followed up for at least 12 months.In the end point of the follow up ,12 of the 14 patients (85.7%)with pauwels type-III femoral neck fractures had achieved satisfactory hip function. Operative duration was a mean of 49.5 ±10.4 minutes.Intraoperative blood loss was between 26 and 110 ml (mean, 44.4±20.6ml) and without intraoperative blood transfusion . The Harris Hip Score was between 64 and 95(mean,87.6±8.9).Fracture healing was observed in all patients according to the X-ray . No internal fixation was loosened or screw cut-out in the follow-up period.The femoral head necrosis was observed in 1 patient in this study. In addition, there was no obvious fracture displacement, femoral neck shortening, or hip varus. Conclusions: The study showed that PSTCS can provide a satisfactory clinical outcomes for treatment of pauwels type-III femoral neck fractures.Most patients (85.7%) achieved good or excellent results with the use of PSTCS,which appears to be a reliable method and provides another choice for this problematic fracture.The new internal fixation method of PSTCS can provide mechanical stability and promote fracture healing

scholarly journals Total Hip Arthroplasty for Femoral Neck Fracture after Postoperative Intertrochanteric Fracture in a Patient with Spontaneous Fused Hip

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Saori Niitsu ◽  
Shohei Okahisa ◽  
Yuki Fujihara ◽  
Yu Takeda ◽  
Shigeo Fukunishi
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Intertrochanteric Fracture ◽  
Harris Hip Score ◽  
Neck Fracture ◽  
Femoral Intertrochanteric Fracture ◽  
One Year ◽  
The One ◽  
End Stage ◽  
Modified Harris Hip Score

A 64-year-old woman with a spontaneous fused hip sustained a left femoral neck fracture. It was revealed that her left hip joint had a long-standing spontaneous hip fusion due to end-stage osteoarthritis. Additionally, she sustained an ipsilateral femoral intertrochanteric fracture and underwent osteosynthesis using a dynamic hip screw 8 years ago. The one-stage THA was successfully treated with no major complications and good functional recovery was obtained. The hip range of motion improved remarkably at one year after surgery. The Modified Harris Hip Score improved from an estimated 70 points before fracture to 95 points at final follow-up.

scholarly journals The Role of The Medial Buttress Plate In The Treatment of Pauwels Type Ⅱ And Ⅲ Femoral Neck Fracture: A Retrospective Study And Preliminary Results

2021 ◽  
Author(s):  
Chao Ma ◽  
Yanshi Liu ◽  
Jialin Liu ◽  
Li Chen ◽  
Jinyong Huang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Statistical Significance ◽  
Implant Failure ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Displaced Femoral Neck Fractures ◽  
Anatomic Reduction ◽  
Neck Fracture ◽  
Buttress Plate

Abstract Background: The purpose of this study was to compare the effectiveness of multiple cannulated screws combined with medial buttress plate or not for the treatment of unstable femoral neck fracture.Methods: 69 nonelderly patients with Garden type III-IV femoral neck fracture were retrospectively analyzed. The patients were divided into MCS (multiple cannulated screws) group and CMBP (combined with medial buttress plate) group according to the surgical method. Patient’s demographic data, Harris Hip Score, EQ-5D index and complications at minimum of 2 years follow-up were analyzed.Results: There were 47 patients in the MCS group (35 male and 12 females) with a mean age of 40.28±12.64 years, whereas 22 patients in the CMBP group (17 male and 5 females) with a mean age of 43.86±12.55 years. In the MCS group, there were one avascular necrosis, five postoperative nonunion, five implant failure, and two femoral neck shortening. While one implant failure, two postoperative nonunion and two impingement in the CMBP group. The difference of HHS scores was statistically significant at 3 months after surgery between the two groups (P<0.05), whereas there was no statistical significance at 6 months, 1 year and 2 years (P>0.05). The same results were found in EQ-5D index.Conclusions: Anatomic reduction and stable fixation contribute to satisfactory outcomes in the treatment of nonelderly displaced femoral neck fractures. A buttress plate in the medial region of the femur neck with cannulated screws offers patients the best biomechanical microenvironment needed for fracture healing without obviously blood-supply disruption, especially in Pauwels type Ⅱ and III.

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>

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