Study of Functional Outcome Following Hemiarthroplasty for Management of Intracapsular Fracture of Neck Femur

Abstract

Background: The neck of femur fracture is one of the common fractures in elderly. Though, Primary total hip replacement is being preferred at many tertiary centers in India. Still its not popular in government hospitals due to high cost and majority of the patient doing well with hemiarthroplasty. Present study was aimed to study functional outcome following Hemiarthroplasty for management of intracapsular fracture of neck femur in elderly patients.

Material and Methods: Present study was prospective, observational study, conducted in patients with X ray proven Intracapsular fracture of femoral neck in elderly patients above age of 60 years, able to rehabilitate, underwent Hemiarthroplasty.

Results: Most of the patients were found to be male. Patients with left side being affected in 47%, with right side about 53 %. Majority of study patients (80%) had a trans- cervical type of fracture Basi cervical – 13.3 % and sub- capital fractures – 6.66%. Most commonly used prosthesis size was 45mm followed by 43mm, 47mm and 41mm and 47 mm 21 patients were cemented, 9 patients were uncemented. Limb lengthening (< 1cm) was observed in two patients (6.66%), limb shortening > 2 cm observed in 5 patients(16.66%) post- operatively due to technical errors in the form of the prosthesis sitting proud of the calcar. On analyzing the anteroposterior view x ray of pelvis with hip in 15 degrees of internal rotation. It was found that 75 percent patient had good results, 25 percent patients with excellent results. Overall, as per Harris Hip Score, 8 patients (26.66%) achieved Excellent result, 14 patients (46.66%) achieved good result, 6 patients (20%) achieved fair result and 2 patients (6.66%) achieved poor result.

Conclusion: Bipolar hemiarthroplasty for fractures of the femoral neck provides freedom from pain and more rapid return to unassisted activity with an acceptable complication rate.