Abstract
Background: Femoral neck fracture or Subcapital fracture of the hip is one of the most common fractures at old age. There is a debate about the use of monopolar monoblock prosthesis for the treatment of those fractures. This paper is a retrospective examination of the functional and ambulation outcome of patients after partial hip replacement with cementless Austin Moore prosthesis. Methods: Between 2002-2009, 320 patients with femoral neck fracture were treated by hip hemiarthroplasty with cementless Austin Moore prosthesis in our department. All patients had displaced femoral neck fractures. The anterolateral approach was used for all operations. Seventy nine patients who underwent 84 hip hemiarthroplasty with cementless Austin Moore prosthesis agree to participate and were enrolled to this study. (Five patients had bilateral femoral neck fracture at separate occasions during the study period). All patients were followed at the out patients clinic and filled a questionnaire about functional and ambulation before fracture and after rehabilitation period. The functional outcome was divided into four levels, Poor Fair Good and Excellent functional ability. The scale of ambulation ability was 1-7 in which 1 is ambulation with no means and 7 is bed or chair ridden. Results: The average functional score before the fracture was 22.87 and 10.43 after surgery. The average ambulation ability before the fracture and after rehabilitation was (1.62) (4.29) respectively. Out of the 320 patients, three prosthetic hip dislocated (0.94%), four were (1.25%) infected and five (1.56%) experienced a periprosthetic fracture. Conclusion: Our study reveals that only small number of patients achieved good or excellent functional and ambulation score. The decline in functional and ambulation ability was statistical significant. We showed a relatively low incidence of complications.
Highlights
Femoral neck fractures of the hip are very common intracapsular fracture at old age, and occur most commonly in women older than age 65 years [1,2]
The functional outcome was divided into four levels, Poor Fair Good and Excellent functional ability
We showed a relatively low incidence of complications
Summary
Femoral neck fractures of the hip are very common intracapsular fracture at old age, and occur most commonly in women older than age 65 years [1,2]. This fracture poses a significant health care problem, with a worldwide annual incidence of approximately 1.7 million which is expected to triple in the 50 years as the population ages [3,4]. Especially in the elderly, the medical and functional status may not return to the pre-injury levels. The adoption of either a surgical or nonsurgical approach requires a multifactorial decision that incorporates the patient’s pre-injury status, including prior hip pain, ambulation, functional and mental capacity, and the complexity of their medical background [1]. This paper is a retrospective examination of the functional and ambulation outcome of patients after partial hip replacement with cementless Austin Moore prosthesis
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