Treatment of femoral neck fractures with duo cup prosthesis

Abstract

Between April 1992 and March 1994 Duo-cup endoprosthesis was inserted in 90 patients (mean age 80 years, 49-99 years) with fractures of the femoral neck, admitted to the Division of Trauma Surgery. University Hospital of Zürich, Switzerland. The purpose of this study was the clinical and radiological evaluation during a follow-up period of 3 to 24 months. The mechanism of trauma, pre-existing morbidity of the patients, operative stress and postoperative complications were analyzed retrospectively. The functional outcome of 75% of the patients was assessed according to a standardized protocol. In the follow-up, 85% of the patients showed good to excellent results. Radiolucent zones around the cement-bone interface were detected by x-ray scan in 7 patients without loosening of the prosthesis. In half of the patient group heterotopic ossifications appeared, but without clinical relevance. Complications appeared as followed: 3.3% superficial infections, 3.3% deep wound infections followed by replacement of the prostheses, 8.8% hematomas, 2.2% extraprothetic luxations. The perioperative lethality was 0%, whereas the lethality during hospitalisation was 2.2% and the average lethality of the first postoperative year 13%. Overall, 93% of the patients returned to their pre-existing housing environment. These results show that good to excellent clinical and functional results can be achieved in the treatment of femoral neck fractures with duo-cup prosthesis in elderly patients which enables the patients to return in their known social environment.