Key result
Hip arthroplasty in elderly patients with femoral neck fractures resulted in a return to pre-injury levels of ambulation for the majority of patients, with a 7% rate of dislocation and 4% rate of deep infection.
Why the study?
Intracapsular fractures of the neck of femur cause major morbidity and mortality in elderly patients, and internal fixation carries high complication and revision rates due to comorbidities and osteoporosis, making replacement a viable alternative.
Observational (n=100)
No
Hip replacement (hemi or total) is a viable and effective treatment for femoral neck fractures in patients over 65, allowing for early mobilization and return to pre-injury functionality.
Answers are grounded in this paper and cite their sources.
Supports hip arthroplasty as a viable strategy for early mobilization in elderly patients; leaves open whether.
Background: Intracapsular fractures of the neck of femur are a major cause of morbidity and mortality in elderly population in India. The primary goal of treatment in these patients is to get the patients to the preinjury level of functionality as early as possible and with minimal complications. Multiple modes of operative treatment in the form of fixation devices (screws, plates, nails) and replacement (hemi or total replacement) are available for this fracture. However, a high rate of complications and revision surgeries has been found after internal fixation in this population group owing to the unique challenges to fixation in the form of co morbidities and osteoporosis among others. Instead of internal fixation, replacement is thus a viable option.Materials and Methods: 100 patients (age >65 years) with a femoral neck fracture were treated over a two-year period (May 2018 to April 2020) with some form of hip replacement after appropriate anesthetic fitness. Results: We had good results in majority of the patients in terms of return to pre-fracture level of functionality, independent ambulation and satisfaction with the results. A majority of patients treated with hemiarthroplasty recovered without incidence while all patients of total hip replacement progressed without incidence. There were 10 cases of suture line infection which recovered satisfactorily with a change of antibiotics, 4 cases of deep infection for which debridement and implant removal was required, 3 cases of deep vein thrombosis and 7 cases of dislocation. Conclusion: Hip replacement is a viable option for treatment of femoral neck fractures in patients more than 65 years of age. Return to preinjury level of functionality is pretty satisfying and early if the patient is actively mobilized as early as possible postoperatively. There are no risks of nonunion, malunion and implant related complications as compared to internal fixation devices.
No takes yet. Share an insight, caveat, or question.
Mate et al. (2020) conducted an observational in Femoral neck fracture (n=100). Hip arthroplasty (hemiarthroplasty or total hip arthroplasty) was evaluated on Return to pre-injury level of ambulation and activities of daily living. Hip arthroplasty in elderly patients with femoral neck fractures resulted in a return to pre-injury levels of ambulation for the majority of patients, with a 7% rate of dislocation and 4% rate of deep infection.
Synapse has enriched 10 related papers. Consider them for comparative context: