Recovery after Hip Fractures: Influence of Bipolar Hemiarthroplasty on Physical Disability and Social Dependency in the Elderly

2011 ◽  
Vol 21 (6) ◽  
pp. 751-756 ◽  
Author(s):  
Johannes Schneppendahl ◽  
Marcel Betsch ◽  
Vanco Petrov ◽  
Friedrich Böttner ◽  
Simon Thelen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Geriatric Patients ◽  
Femoral Neck Fractures ◽  
Bipolar Hemiarthroplasty ◽  
Displaced Femoral Neck Fractures ◽  
Neck Fracture ◽  
Original Type

Surgical treatment of femoral neck fractures is associated with a significant impact on quality of life. The aim of this study was to determine the long-term influence of displaced femoral neck fractures treated by bipolar hemiarthroplasty on the activities of daily living, quality of life and social dependency. We studied 487 geriatric patients treated in the years 1989 to 2003. At the beginning of follow-up in 2004, 166 patients were alive and evaluation was carried out on 145 patients (87.3%) at 91.3 (14 - 244) months postoperatively by a standardized questionnaire. All enrolled patients had been treated with cemented bipolar hemiarthroplasty for a displaced femoral neck fracture. Patients were evaluated concerning their average pre- and postoperative ability to walk, the need for assisting devices, type of residency and the SF-12® Score. Femoral neck fracture and hemiarthroplasty had a significant influence on all recorded aspects of quality of life. Even though almost two thirds of the patients needed assisting devices to walk after surgery, about two thirds returned to their original type of accommodation and the majority reached their original degree of mobility. Compared to a normal population no significant impact was observed on the quality of life measured by the SF-12® score. We consider bipolar hemiarthroplasty an effective treatment option for displaced femoral neck fractures in geriatric patients. Most patients returned to their original type of accommodation and level of mobility, even though the majority required a number of assisting devices to do so.

scholarly journals Patient-Perceived Quality of Life after Total Hip Arthroplasty: Elective versus Traumatological Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Alessandro Aprato ◽  
Alessandro Massè ◽  
Francesco Caranzano ◽  
Renato Matteotti ◽  
Patrick Pautasso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Womac Score ◽  
X Rays ◽  
Length Discrepancy ◽  
Neck Fracture ◽  
Group A ◽  
Group B

Purpose. The aim was to evaluate and compare patient's health-related quality of life after THA for osteoarthritis and femoral neck fracture. The postoperative outcome was retrospectively evaluated in patients who underwent THA with an intracapsular femoral neck fracture (Group A) or with an hip osteoarthritis (Group B). Methods. Length discrepancy was measured on postoperative X-rays. Study groups were compared as to age, results of WOMAC and SF-36 tests, limb length discrepancy (LLD) by independent group t-test. Correlations between LLD and results obtained atWOMAC test were performed. 117 patients were enrolled. The 2 groups were similar as to age, type of implanted stem and sex. Mean follow up was 2,4 years for group A and 2,3 years for group B. Results. WOMAC score was found higher in group A in all items examinated. Correlation tests did not indicate a statistically significant linear relationship between LLD and WOMAC score in both groups. Conclusions. Patients who received THA for arthritis have better perception of quality of life than traumatologic patients. Although LLD should always be strongly considered by the surgeons performing a THA, LLD alone can't be considered as an indicator of patient dissatisfaction or clinical bad result after a 2-year followup.

scholarly journals Internal Fixation Versus Hemiarthroplasty for Displaced Intra-Capsular Femoral Neck Fractures in ASA 3-5 Geriatric Patients

2016 ◽  
Vol 10 (1) ◽  
pp. 765-771 ◽  
Author(s):  
W. Rezaie ◽  
W. Wei ◽  
B.I. Cleffken ◽  
C.H. van der Vlies ◽  
B.I. Cleffken ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Femoral Neck Fracture ◽  
Geriatric Patients ◽  
Mortality Rates ◽  
Femoral Neck Fractures ◽  
Inclusion Criteria ◽  
Operation Rate ◽  
Neck Fracture ◽  
The Mean

Background: The treatment of choice for elderly with a displaced intra-capsular femoral neck fractures is prosthetic replacement. This is however a major surgical procedure for geriatric patients with multiple co-morbidities which can threaten hemodynamic stability and lead to death. In this study we compared the outcome of internal fixation (IF) versus hemiarthroplasty (HA) for the management of intra-capsular femoral neck fractures in the elderly with severe co-morbidities. Methods: We conducted a retrospective cohort study of all the patients who were admitted to our Level-II trauma centre with a femoral neck fracture between January 2009 and June 2011. Inclusion criteria were: 70 years or older, ASA 3 or higher, a displaced femoral neck fracture and treatment with either internal fixation or a cemented hemiprosthesis. The primary outcome was 6-month mortality rate. Secondary outcomes were 30-day mortality, post-operative complications, re-operation rate and length of hospital stay. Results: 80 patients met our inclusion criteria. The mean age of the IF group was 81.6 years and in the HA group it was 84.5 years (P=0.07). The medical records were retrieved 34-64 months after surgery. Two intra-operative deaths due to cement implantation syndrome were found in the HA group and none in the IF group. Twelve patients (21.8%) in the HA group died within 30 days after surgery and 2 (8.0%) in the IF group (P=0.21). The mean operating time was 83 min. for the HA group and 51 min. for the IF group (P=0.000). There were more implant-related complications in the IF than in the HA group (36% vs 9.1% respectively, P=0.008). The 6-month mortality rates didn’t differ between the IF and the HA groups (respectively 28.0% vs 34.5%, P=0.62). Conclusion: The post-operative mortality rates did not differ between the IF and the HA groups in elderly patients with a displaced femoral neck fracture and ASA 3 to 5. However, the HA associated with less implant-related complications than the IF in this group and it is therefore the treatment of choice.

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 Threading the Needle: Intrapelvic Displacement of a Femoral Neck Fracture through the Obturator Foramen

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Gautham Prabhakar ◽  
Nicholas Kusnezov ◽  
Nicholas Rensing ◽  
Amr Abdelgawad
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Femoral Neck Fracture ◽  
Young Patient ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Obturator Foramen ◽  
Displaced Femoral Neck Fractures ◽  
Anatomic Reduction ◽  
Neck Fracture

Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature. We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen into the pelvis without associated acetabular or pelvic injury.

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