A Prospective Study of Bipolar Hemiarthroplasty, In the Management of Intracapsular Fracture Neck Femur in Elderly

Abstract

Background and Objectives: ABSTRACT A hip fracture represents a significant cause of morbidity and mortality in all age groups, especially in elderly. The ideal treatment of intracapsular fracture of the proximal femur in elderly has been the replacement hemiarthroplasty, in view of senile osteoporosis, frequent development of nonunion, failure of osteosynthesis and avascular necrosis of the femoral head. Comparitive studies between unipolar and bipolar hemiarthroplasties have shown that the rate of reoperation reduced to half, the ambulatory capacity and pain relief also were better in patients treated with bipolar hemiarthroplasty as compared to unipolar hemiarthroplasty. The use of a bipolar prosthesis has led to a decrease in the amount of the acetabular cartilage erosion. The goal of the current study is to assess the functional outcome and quality of life in the patients treated with bipolar prosthesis for intracapsular fracture neck femur. Methods: The present One year prospective study was conducted in the Department of Orthopaedics, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 30 patients who sustained an intracapsular femoral neck fracture during the period December 2007 to November 2008. Patients were followed up at an interval of six weeks, three months and sixth month, and their Functional Outcome was assessed using Harris Hip Score. viii Results : In this study, majority of the patients were in the age group of 55 to 65 years. Males were most commonly affected. Predominantly right side was involved and fall on a slippery floor was the common mode of injury. In majority of the cases , surgery was performed within 4 days of admission. Using Harris Hip Score ,we achieved 83.33% excellent to good results, with an average Harris Hip score of 84.81 points. Conclusion and interpretation: After treating 30 patients with intracapsular fracture neck of femur, with Bipolar prosthesis, we feel that, it has a better advantage over Austin Moore prosthesis in terms of stability, mobility, range of motion and functional results.