EVALUATION OF DIFFERENT TYPES OF ARTHROPLASTY IN THE TREATMENT OF FEMORAL NECK FRACTURE
Murat Ali HERSEKLİ1, O Şahap ATİK2
1Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Adana
2Gazi Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı
Keywords: Femoral Neck Fracture, Arthroplasty.
Abstract
Introduction: Although there have been great advances in the treatment of femoral neck fractures since 1950's, the advantages and the disadvantages of various treatment methods have led to a lack of consensus on this subject. The appropriate treatment method is of great importance for keeping the mortality and morbidity at the minimum level.
Patients and methods: One hundred and fifty acute displaced femoral neck fractures in the elderly patients were treated with different types of arthroplasty at the Department of Orthopaedic and Traumatology of Gazi University Faculty of Medicine between 1.11.1990 and 31.12.1996. Average age was 73.0 (48-95). All of the patients had Garden type III and IV displaced fractures. 25 patients were treated with total hip replacement, 21 patients with bipolar hemiarthroplasty and 104 patients with unipolar hemiarthroplasty. Average follow up period was 63.79 months (12-89) in the total hip replacement group, 26.75 months (12-42) in the bipolar hemiarthroplasty group and 36.05 months (12-75) in the unipolar hemiarthroplasty group. Pain, walking and function were rated on a ten-point scale (with ten being best) using the University of California, Los Angeles (UCLA) hip rating system. Mortality, morbidity, loosening, dislocation, acetabular erosion and heterotopic ossification were also evaluated.
Results: According to the results of the study, there was no difference in pain and walking among the groups. The functional result of total hip replacement group was the best of all. In the study, there was no significant difference among the groups about mortality, morbidity, loosening, dislocation, acetabuler erosion and heterotopic ossification.
Discussion: Besides performing total hip arthroplasty to patients with femoral neck fracture accompanied by degenerative arthritis, to perform the same procedure to relatively young patients who can be actively mobilized among community can cause promising results.