The functional outcome in patients treated with THA with acute fracture neck of femur in patients aged above 60 years using Harris hip score

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity, mortality and loss of independence. To avoid the drawbacks of internal fixation and for early mobilization, hemiarthroplasty is performed in elderly. The bipolar prosthesis was developed to overcome the shortcomings of the unipolar fixed-head prosthesis. An additional site of motion would be expected to decrease the amount of loosening, dislocation, and head migration. The aim of the study is to assess the functional outcome of the patients with fracture neck of femur treated with bipolar hemiarthroplasty.Methods: In this study, 20 patients above the age of 60 years with acute displaced fracture neck of femur underwent hemireplacement arthroplasty with bipolar prosthesis in Department of Orthopaedics, KIMS, Bangalore. The patients were followed up on 6th, 12th, 18th, 24th week post operatively. Functional outcome was assessed with Harris hip score.Results: In our study, mean average age was 72.3 years with predominantly female patients with 75% of the patients with left sided fracture. 95% of the patients had slight or no pain, 85% of patients had slight or no limp. 50% of the patients could walk without support, 65% of the patients could walk a distance of 6 blocks or more. Average Harris hip score was 82%.Conclusions: These results suggest functional outcome following bipolar hemiarthroplasty is good. Early mobilisation, pain free hip and with good level of activity is obtained following bipolar hemiarthroplasty.

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Surgical management of basicervical fracture neck of femur with dynamic hip screw and derotation screw: a prospective study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20192690 ◽

2019 ◽

Vol 5 (4) ◽

pp. 712

Author(s):

Vijaykumar S. Kulambi ◽

Ajay Shringeri Satish ◽

Prathik Rangaraja

Keyword(s):

Functional Outcome ◽

Dynamic Hip Screw ◽

Harris Hip Score ◽

Care Hospital ◽

Fracture Union ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Hip Screw ◽

One Year ◽

Modified Harris Hip Score

Background: Basicervical region of femur is that part of femur which is intermediate between neck and intertrochanteric region. Fracture in this region carry substantially higher chances of failure due to greater fracture angle and are rotationally unstable. If treated inadequately they carry very high chances of fracture non-union and theoretically risk of osteonecrosis. The objective of the study was to analyse functional outcome of basicervical fracture neck of femur fixation with dynamic hip screw and de-rotation screw in a tertiary care hospital.Methods: 35 cases of basicervical fracture neck of femur admitted in Chigatteri General Hospital and Bapuji Hospital affiliated to JJM Medical College Davangere, in the period of October 2015 to October 2018. Functional outcome was assessed according to Modified Harris Hip Score after one year of follow up.Results: The fracture union was found in 100% cases, average time period for fracture union was 12.28±3.71 weeks (11-15 weeks range). The results according to Modified Harris hip score were excellent in 70%, good in 11.4%. good in 5.7% and poor in 2.8% at the end of one year. The correlation analysis with Pearson’s correlation coefficient (r) was 0.74 which show a highly positive correlation between the union of basicervical fracture neck of femur with dynamic hip screw and derotation screw.Conclusions: With the study of 35 cases of basicervical fracture neck femur we conclude that these are a unique type of fractures mid-way between neck and intertrochanteric fractures with rotational and axial instability, and also risk of osteonecrosis. DHS allows for controlled collapse of the fracture for uneventful healing, and de-rotation screw gives rotational stability.

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Evaluation of functional outcome of displaced fracture neck of femur in elderly treated with cemented bipolar prosthesis by modified Harris hip score

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211610 ◽

2021 ◽

Vol 7 (3) ◽

pp. 561

Author(s):

Shivakumar B. Kerakkanavar ◽

Deepak P. Kaladagi ◽

Nagesh B. Sanakal ◽

Pundaleekappa S. Kaladagi ◽

Praveenkumar A. Hongal

Keyword(s):

Elderly Patients ◽

Functional Outcome ◽

Hip Prosthesis ◽

Limb Lengthening ◽

Harris Hip Score ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Femur Fractures ◽

Modified Harris Hip Score ◽

Displaced Fracture

Background: The current research was conducted to determine the functional outcome of the displaced fracture neck of femur in elderly patients treated with cemented bipolar hip prosthesis.Methods: The present research was a prospective study of 44 cases of displaced fracture neck of femur admitted to our institute between October 2017 and October 2019. Cases were chosen on the basis of inclusion and exclusion criteria. Cases were surgically treated with cemented bipolar hip hemiarthroplasty and functional findings were recorded with modified Harris hip score.Results: In our series of 44 cases there were 30 females and 14 males, with a maximum age of 92 years, minimum age of 65 years, and the average age was 72.72 years. At one-year follow-up, the average modified Harris hip score was 86.75% (maximum score of 95 and a minimum score of 66), overall, 20 patients (45.46%) achieved excellent, 16 patients (36.36%) achieved good, 5 patients (11.36%) achieved fair and 3 patients (6.82%) achieved poor results. 81.82% of the patients returned to the pre-fracture level of activity and independent ambulation. Patients had few complications like limb length discrepancy, 36.3% of patients had limb lengthening between 1 to 1.5 cm.Conclusions: In elderly patients with displaced neck femur fractures, cemented bipolar hip prosthesis provides good functional outcome. However further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups is required.

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Functional outcome of fracture neck of femur treated with total hip replacement versus bipolar arthroplasty in a South Asian population

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-006-0182-x ◽

2006 ◽

Vol 126 (8) ◽

pp. 545-548 ◽

Cited By ~ 9

Author(s):

K. Karthik Narayan ◽

Thomas George

Keyword(s):

Functional Outcome ◽

Total Hip Replacement ◽

South Asian ◽

Hip Replacement ◽

Asian Population ◽

South Asian Population ◽

Neck Of Femur ◽

Total Hip ◽

Fracture Neck Of Femur

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AUSTIN MOORE PROSTHESIS IN THE MANAGEMENT OF FRACTURE NECK OF FEMUR IN AN ELDERLY POPULATION.

10.36106/ijsr/3825631 ◽

2020 ◽

pp. 73-75

Author(s):

Ravi Kumar ◽

Chandan Kumar

Keyword(s):

Functional Outcome ◽

Treatment Option ◽

Elderly Population ◽

Tertiary Care ◽

Walking Distance ◽

Neck Of Femur ◽

Protrusio Acetabuli ◽

Fracture Neck Of Femur ◽

Austin Moore

Introduction: Intracapsular fractures of the proximal femur form a major share of fractures in the 77 elderly. Hip replacement arthroplasty (partial or total) is emerging as a most viable treatment option, and in that, hemiarthroplasty with the Austin Moore Prosthesis is among the most commonly employed. In our study, we have made an attempt to assess the functional status at long term follow up after hemiarthroplasty with the AMP, used in the treatment of fracture neck of femur in the elderly population, and to substantiate the use of the prosthesis in modern day orthopaedic practice. Materials and : A retrospective study was carried out in patients above the age of 60 years, who had been diagnosed with non-pathological fracture neck of femur, treated operatively with hemiarthroplasty using the Austin Moore prosthesis in a tertiary care centre. A minimum follow up period of two years was considered. All the patients were evaluated clinically, and wherever possible, radiologically. Functional outcome was assessed based on the Harris Hip scoring system, and the results were analysed. Radiologically, an attempt was made to assess, among others, the amount of protrusio acetabuli at follow up, and femoral offset changes following hemiarthroplasty with the AMP. Results: In our study, we observed a positive functional outcome (excellent or good) in 9(45%) patients, with fair result in 6(30%) and poor in 5(25%). However, when pain alone was taken as criteria for assessment, upto 14(75%) patients had none to slight pain at follow up, and only 1(5%) patient had marked pain. Walking distance was significantly reduced in 6(30%) patients, who were either confined indoors or bedridden, but in only 1(5%) of them, the cause for the decreased ambulatory status was implant or procedure related (pain). Among the complications, 1 patient had a post-operative periprosthetic fracture that healed subsequently, 2 patients had marked osteolysis around the stem of the prosthesis, and only 1 patient had a radiological evidence of protrusio acetabuli. Discussion: Hemiarthroplasty with Austin Moore Prosthesis for fracture neck of femur remains a fairly good treatment option in elderly patients.

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Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

10.53350/pjmhs21155988 ◽

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

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Outcome of fibular strut graft and two cannulated hip screws in neglected fracture neck of femur in adults - 10 years review

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i1.27073 ◽

2019 ◽

Vol 6 (1) ◽

pp. 25-30

Author(s):

Rajendra Sanjel Chhetri ◽

Kishor Prashad Khatri ◽

Krishna Kharel

Keyword(s):

Avascular Necrosis ◽

Delayed Union ◽

Harris Hip Score ◽

Outcome Analysis ◽

Fracture Union ◽

Neck Of Femur ◽

Strut Graft ◽

Non Union ◽

Fracture Neck Of Femur ◽

Fibular Strut

Introductions: Avascular necrosis and non-union are common but when the neck of femur fracture in adult is neglected, the chances of complications rises. Among various treatment options, we report the outcome of free fibular strut graft along with two cannulated hip screws in neglected fracture neck of femur. Methods: The outcome analysis of ‘fibular strut graft and two cannulated hip screws’ was conducted in patients with fracture neck of femur who presented at least three weeks after the time of injury, during August 2008 to December 2017, at Lumbini Zonal Hospital and Lumbini Hospital Technical College, Butwal, Nepal. All adult patients aged 18 to 60 years were included. Outcome variables were healing of fracture (union, delayed union, non-union), avascular necrosis and Harris Hip Score (HHS). Results: Out of 20 fractures, 17 (85%) united uneventfully, 2 (10%) had delayed union and 1 (5%) nonunion. We had 3 (15%) avascular necrosis of femoral head. The HHS was excellent in 8 (40%), good in 4 (20%), fair in 6 (30%) and poor in 2 (10%). Conclusions: Fibular Strut graft with two hip screws resulted in fracture union and improved hip functions in patients with neglected fracture of neck of femur.

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Clinical profile of patients with acute fracture neck of femur

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2019.v5.i2q.1495 ◽

2019 ◽

Vol 5 (2) ◽

pp. 1142-1144

Author(s):

Dr. Mahesh Kumar Reddy V ◽

Dr. Gowtham G ◽

Dr. Abhinav Gandra ◽

Dr. Rahul Shah

Keyword(s):

Clinical Profile ◽

Neck Of Femur ◽

Acute Fracture ◽

Fracture Neck Of Femur

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WITH REGARDS TO THE CLINICO-FUNCTIONAL OUTCOMES, IN BETWEEN FQPP OR BDSF TECHNIQUE, WHICH IS SUPERIOR, AS A CANCELLOUS SCREW FIXATION OPTION, FOR FRACTURE NECK OF FEMUR.

10.36106/ijsr/6104584 ◽

2021 ◽

pp. 53-56

Author(s):

Vijayaselvan S ◽

Venkatachalam K

Keyword(s):

Femoral Head ◽

Screw Fixation ◽

Harris Hip Score ◽

Cancellous Screw ◽

Neck Of Femur ◽

Double Support ◽

Fracture Neck Of Femur ◽

Classi Cation ◽

Poor Outcomes ◽

Four Quadrant

Fracture Neck of Femur are common and one among the most challenging Orthopaedic trauma cases. Many a factors like age, time elapsed after occurrence of injury, presence of other musculo-skeletal trauma and presence of other co-morbid conditions, are all to be taken into account, before embarking on any surgical intervention. Given the precarious blood supply of the femoral head, AVN of the femoral head is a signicant complication in the displaced fractures. Among the various classication systems available, the Garden classication is still in vogue, as highlighted by Guyton J.L et al; (1). The purpose of this prospective study, is to establish the superiority or otherwise of the 'Four Quadrant Peripheral Parallel (FQPP) Screw Fixation” technique, over the “Biplanar Double Support Screw Fixation (BDSF)” technique, when opting for multiple percutaneous cancellous screw xation, for fracture neck of femur. The age group in our study included patients from 26 years to 55 years and had a total of 18 patients, who were recruited in between March 2018 to February 2020. Of these 18 patients, 9 patients were treated by the FQPP technique and another 9 patients by the BDSF technique. All cases were followed-up for at least 1 year (range: 12 to 35 months, mean 18 months). Evaluation was done by Harris Hip Score (HHS) (2). In the FQPP group, 55.56% (n=5) patients had good to excellent results, 22.22% (n=2) patients had fair and 22.22% (n=2) patients had poor outcomes. In the BDSF group 66.67% (n=6) patients had good to excellent results, 22.22% (n=2) patients had fair and 11.11% (n=1) patient had poor outcome. Thus, the results were only just marginally better for the BDSF group, in comparison to the FQPP group and hence, no substantial deductions could be made favoring the superiority of one xation type over the other.

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