Bipolar Hemiarthroplasty Inserted with Cement for the femoral Neck Fractures in Elderly Patients

Park, Sang Won; Byun, Young Soo; Lee, Gyou Hyouk; Kim, Jong Won

Abstract

Elderly patients with femoral neck fracture often have other medical diseases, poor bone quality and poor compliance which make it more difficult to obtain satisfactory results after internal fixation. Therefore, prosthetic replacement is accepted as an appropriate treatment for elderly patients. The purpose of this study was to analize clinical results of cemented bipolar hemiarthroplasty in the femoral neck fractures of elderly patients. The authors analyzed thrity-seven patients with 38 fractures of the femoral neck older than 65 years of age who were treated with cemented bipolar hemiarthroplasty from Jan. 1991 to Dec. 1995. The average follow-up period was three years, ranged from one to five years. The functional results were evaluated according to the criteria of the Harris hip score The results obtained were as follows : 1. The average Harris hip score was 84.6 points, ranged from 61 to 97 points. 2. The average pain score was 40.3 points. Twelve cases did not complain of pain, slight pain in 26 cases and mild pain in 2 cases. 3. The average limping gait score was 8.9 points. Twelve cases had no limping gait, slight limping in 25 cases and moderate limping in one case. 4. The average support score was 8.4 points. Seventeen cases could be walked without support, sixteen cases did use cane for long walk, two cases did use cane at full time, and three cases did use crutch. 5. Intraoperative complications were partial fracture of greater trochanter in 2 cases and one non-displaced calcar fracture. 6. Postoperative complications were heterotopic ossification in 2 cases, dislocatioin of bipolar cup with proximal migration in 1 case and ipsilateral femur fracture below the tip of femoral stem in 1 case. Above results suggest that the cemented bipolar hemiarthroplasty for femoral neck fracture in elderly patients appears to be a method of treatment better than internal fixation for early ambulation and functioinal recovery.