Bipolar Hemiarthroplasty for the Treatment of Femoral Neck Fracture in Elderly Patients

Roh, Kwon Jae; Kim, Dong Wook

Abstract

Displaced intracapsular fracture of the hip remains a formidable problem in orthopaedic management despite advances in surgical technique and hardware. Advances in internal fixation have lowered the morbidity from prolonged bed rest and shortened the time of mobilization , however, the incidence of nonunion End avascular necrosis remains high. As a result, prosthetic replacement has been advocated as a solution to this problem. But, sepsis, dislocation and late loosening remain real concoern. So we reviewed the follow-up(range, twelve to sixty months) results of forty bipolar hemiarthroplasty for the displaced femoral neck fracture in elderly patients. The average age of the patients was seventy-four and the common cause of injury was slipped down. In the type of fracture, anatomically subcapital(21), Garden stage IV(19), and Pauwel typeII (21) was the most common. The associated medical conditions were chronic lung disease(10), chronic heart disease(8), diabetes mellitus(7), chronic liver disease(5). Two patients died of hepatoma and liver cirrhosis during the follow-up periods. The results were followed; 1. The most common used prosthesis was Centralign and cement was used in 32 cases. 2. Above 80% wereexcellent or goodin Luncefords criteria and Harris hip score. 3. The complications were transient peroneal nerve palsy(2), intractable thigh pain(2), deep wound infection(1), proximal femoral fracture(1). In conclusion, bipolar hemiarthroplasty seems to be a good alternative to the internal fixation in elderly patients with a displaced femoral neck fracture.