Abstract
Background: The present study was conducted to compare outcome of hemiarthroplasty with dynamic hip screw for basicervical neck of femur fracture.
 Methods: Hospital based, randomized prospective, comparative interventional study conducted on Basicervical neck of femur fracture cases attending with orthopaedics department of S.M.S. Medical College and Hospital, Jaipur (Rajasthan, India)
 Results: As per the post operative complications in Hemiarthroplasty and DHS groups respectively, no significant difference was observed among the group. As per the age groups clinical score (merle's d aubigne), at 6m and 12 m Group H was better than group D. As per average functional outcome at 3,6 ,12months. Score improved with the time.
 Conclusion: We concluded that Hemiarthroplastymay allow better restoration of function and should be favoured for treatment of fracture neck of femur in patients that meet the indications for surgery whenever the technical competence and facilities exist.
 Keywords: Femur, Hemiarthroplasty, DHS
Highlights
A hip fracture is a life changing event for any patient and the risk of disability, increased dependence and death is substantial
We concluded that Hemiarthroplastymay allow better restoration of function and should be favoured for treatment of fracture neck of femur in patients that meet the indications for surgery whenever the technical competence and facilities exist
Mue DD et al (2013) 6observed that Post-operative hip functional status done according to Merle d Aubigne scoring system at 4 – 6 months postop revealed that patients mean hip score was 15±1(Good) and17±1(Very Good) for Hemiarthroplasty and Dynamic hip screw (DHS) groups respectively which was statistically significant (P=0.000) with 69.0% having satisfactory hip function {Very Good(23.0%) and Good(46.0%)} in the hemiarthroplasty group and 92.3% having satisfactory hip function {Excellent(65.4%), Very Good(15.4%), Good(11.5%)}in the DHS group
Summary
A hip fracture is a life changing event for any patient and the risk of disability, increased dependence and death is substantial. The DHS is based on“tension band principle” which allows thescrew to slide within the barrel to enablecompression of the fracture when the patient begins to bear weight with consequent highrates of union and restoration of hip function topre injury level.[4]. The commonest mechanicalfailure of fixation in using the sliding hip screwsystem is cut out of the implant from the femoral head and failure rate of 8%-13% has been reported in previous studies This ismost frequent in elderly patients who usuallyare not able to walk without weight bearing and oftennecessitates revision or a secondaryhemiarthroplasty. It is important thatthe technique of screw placement is precise and should ideally be central in the femoralneck, on both anteroposterior and lateralradiographs This is why the concept of tip apexdistance (TAD) is critical to the outcome offixation and accurately predicts failure or survival of the DHS.[5]
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