SHORT TERM FUNCTIONAL OUTCOME OF TRANSCERVICAL NECK FEMUR FRACTURE MANAGED WITH BIPOLAR HEMIARTHROPLASTY

2021 ◽  
pp. 45-47
Author(s):  
Amol K Salve ◽  
S S Bava ◽  
Vinod Kumar Yadav ◽  
Ajay M Wankhade ◽  
Tanay Nahatkar ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Excellent Outcome ◽  
Bipolar Prosthesis ◽  
Good Outcome ◽  
Operative Assessment

Background: Femoral neck fractures are commonly seen in elderly people. Hemiarthroplasty remains the most common modality of treatment with bipolar prosthesis, which claimed to have a lower incidence of complications. Hence the present study was undertaken to evaluate the functional outcome of intracapsular fracture of femoral neck with cemented or uncemented bipolar prosthesis in elderly Indian population. Method: Total 43 elderly patients were enrolled and operated after being put into lateral decubitus position by the lateral approach or posterior approach of Moore. Modied harris hip score (HHS) was used for analysis of functional outcome, X ray for radiological and patients' pain was assessed by VAS scoring and nally all three parameters compiled and analyzed. Results: The mean age of patients was 68.58 years. Majority of patients had Garden grade III (62.79%) and right sided hip fractures (72.09%). Most of the patients were managed using cemented prosthesis (74.41%) with 45mm prostheses (44.18%). On immediate post-operative assessment, 39 of the 43 patients had fair outcome. At 6 and 12 weeks, 36 and 39 patients respectively had good outcome by HHS. At 6-month follow-up, 30 patients had good outcome while 11 patients had excellent outcome and one patient was died. There was signicant decrease in the VAS score till 6-month follow-up. 40 of the 43 patients had a stable stem xation while 3 patients showed signs of unstable xation. Conclusion: Patient with fractures of the femoral neck get more pain free interval and more rapid return to unassisted activity after bipolar hemiarthroplasty with an acceptable complication rate.

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

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>

FUNCTIONAL OUTCOME OF PIRIFORMIS MUSCLE SPARING POSTEROLATERAL APPROACH IN BIPOLAR HEMIARTHROPLASTY: A RETROSPECTIVE STUDY.

2021 ◽  
pp. 30-32
Author(s):  
Nadeem A. Lil ◽  
Vipul R. Makwana ◽  
Arjav R. Patel ◽  
Aakrut S. Modi ◽  
Tirth D. Patel ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Single Case ◽  
Tertiary Care ◽  
Hip Dislocation ◽  
Posterolateral Approach ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Care Hospital ◽  
Piriformis Muscle

INTRODUCTION: Hemiarthroplasty for hip fracture is a common surgical procedure and is the treatment of choice for displaced intracapsular neck of femur fracture. Numerous approaches are used to access the hip joint. The standard posterior approach is used by many surgeons to preserve the abductor complex but is associated with higher dislocation rate. In this study we assess functional outcomes of piriformis sparing posterolateral approach for hemiarthroplasty of hip. MATERIAL AND METHODOLOGY: We retrospectively reviewed 96 patients who underwent bipolar hemiarthroplasty of hip performed by chief surgeon between May 2018 to September 2020. All the database was retrieved from institutional database of tertiary care hospital. Functional outcome was measured by modied HARRIS HIP SCORE. RESULTS: Till minimum 1 year follow up we noticed that there was no single case of hip dislocation. Joint proprioception was preserved. In the nal follow up average Harris hip score was 92.2. No infection, nerve injury, implant migration occurred in our study. DISCUSSION: The main aim of the arthroplasty procedure is to decrease pain, to achieve mobility and restore anatomy. The piriformis sparing approach not only preserves abductor complex but also piriformis muscle. The muscle works like cradle, at the posterosuperior part of the joint, an area with a high risk of dislocation. The only disadvantage was noted in this approach was increased exposure difculty in obese patients CONCLUSION: From this study we conclude that Piriformis sparing posterolateral approach is safe, demands some technical aspects and should be used by surgeons using posterolateral approach.

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 Surgical management of intracapsular fracture neck femur by hemiarthroplasty between uncemented bipolar prosthesis and Austin Moore’s prosthesis: a comparative study in elderly population

2019 ◽  
Vol 5 (4) ◽  
pp. 612
Author(s):  
H. D. Veeranna ◽  
K. B. Ravi ◽  
K. Anudeep Kumar
Keyword(s):  
Femoral Neck ◽  
Elderly Population ◽  
Early Mobilization ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Bipolar Prosthesis ◽  
Fracture Neck Femur ◽  
Displaced Femoral Neck Fractures

<p class="abstract"><strong>Background:</strong> Intracapsular femoral neck fractures are common in elderly population after a simple fall. To avoid the drawbacks of internal fixation and for the early mobilization, hemiarthroplasty is performed in elderly. The aim of this study is to compare the outcome AMP with uncemented bipolar prosthesis in geriatric patients.</p><p class="abstract"><strong>Methods:</strong> 51 patients above 60 years and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either AMP (Austin Moore prosthesis) or bipolar hemiarthroplasty, in the Department of Orthopaedics, Sri Siddhartha medical college, Tumkur between April 2014 and May 2017. The patients were summoned at 6 weeks, 12 weeks, 6 months and 1 year. Functional outcome was assessed and compared with modified Harris hip score and radiological parameters.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean Harris hip score in bipolar and AMP group was 86.31±12.1 and 79.86±15.42, respectively (p=0.182). The range of motion was 204.52±28.2 and 183.62±36 (p=0.014) respectively. Functional activities like use of public transport and ability to wear shoe or socks was better with bipolar group. Incidence of complications like painful hip, posterior dislocation, periprosthetic fracture and acetabular erosion was encountered in AMP group.</p><p class="abstract"><strong>Conclusions:</strong> The use of uncemented bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur.</p><p class="abstract"> </p>

scholarly journals Prospective study of the functional outcome of uncemented bipolar hemiarhroplasty in displaced fracture neck of femur in elderly

2020 ◽  
Vol 6 (3) ◽  
pp. 567
Author(s):  
Radhakrishna A. Mallegowda ◽  
Channappa T. Seetharam ◽  
Shivanand Sundaram ◽  
Jayaram B. Siddegowda ◽  
Veeresh Nijalingappa
Keyword(s):  
Functional Outcome ◽  
Early Mobilization ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Bipolar Prosthesis ◽  
Fracture Neck Of Femur ◽  
Excess Morbidity ◽  
Predominantly Female ◽  
Displaced Fracture

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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%.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

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