Hip Pelvis.  2013 Sep;25(3):197-202. 10.5371/hp.2013.25.3.197.

The Total Hip Replacement Arthroplasty for Femur Neck Fractures in the Elderly

• Cho JH
• Ryu CH
• Han KY

• KMID: 1974375
• DOI: http://doi.org/10.5371/hp.2013.25.3.197

Abstract

PURPOSE
To analyze the clinical and radiological outcomes of total hip replacement arthroplasty (THRA) for the treatment of femur neck fractures in the elderly.
MATERIALS AND METHODS
Femur neck fracture patients older than70 years of age, who showed good preoperative walking ability without dementia,and underwent THRA between February, 2008 and March, 2010 were reviewed retrospectively. Twelve patients(13 hips) were enrolled and the mean ages of the patients were 79.4(70-91). The mean follow-up period was 31(20-49) months. The modified Koval index was used to determine the clinical outcome. Inclination and anteversion of acetabular cup, loosening, osteolysis, periprosthetic fractures and dislocations were evaluated using the radiographs.
RESULTS
The modified Koval index decreased from 4.92 to 4.84 at the final follow-up, but the decrease was not significant (P=0.339). Dislocations occurred in 2 cases postoperatively(2/13, 15.4%). No other complications were encountered.
CONCLUSION
The THRA for the treatment of femur neck fractures in elderly patients over 70 years of age showed satisfactory clinical and radiological outcomes. Nevertheless, caution should be taken regarding the relatively high incidence of postoperative dislocations.

Keyword

Femur neck; Fractures; Old age; Total hip replacement arthroplasty

MeSH Terms

Aged*
Arthroplasty*
Arthroplasty, Replacement, Hip*
Dislocations
Femoral Neck Fractures*
Femur Neck*
Femur*
Follow-Up Studies
Humans
Incidence
Osteolysis
Periprosthetic Fractures
Retrospective Studies
Walking

Figure

• 

  Fig. 1 Porous coating acetabular cup and minimal collar polished stem were used in these series (Implantcast, Buxtehude, Germany).

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  Fig. 2 Seventy-eight female patient was admitted for right femur neck fracture (A) Preoperative radiograph showed Garden type IV femur neck fracture. (B, C) Total hip replacement arthroplasty was done. (D, E) Posterior dislocation occurred at postoperative 3 weeks.

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