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

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.

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

<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>

A comparative study on functional outcome of unstable intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw fixation: a short term perspective analysis

<p class="abstract"><strong>Background:</strong> Trochanteric hip fractures in elderly patients have benefited from advances in internal fixation. Early failure of internal fixation occurs however in a number of cases. The failure after internal fixation had been due to initial fracture pattern, communication, sub-optimal fracture fixation and poor bone quality. The aim of this prospective comparative study is to analyze the short term follow up results of unstable Intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw (DHS) fixation.</p><p class="abstract"><strong>Methods:</strong> This is a study conducted in the Department of Orthopaedics, Government Tiruvarur Medical College, Tiruvarur. 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases).<strong></strong></p><p class="abstract"><strong>Results:</strong> 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases). Patients were evaluated clinically using the Harris hip score during their follow up period. In both groups, the most common Singh’s index was grade III, 61.90%in both group A and group B.</p><p class="abstract"><strong>Conclusions:</strong> From our results, we are of the opinion that bipolar hemiarthroplasty may be an efficient option in elderly osteoporotic intertrochanteric fractures. It reduces the potential complications of prolonged immobilization such as pressure sores, pulmonary complications by early mobilization.</p>