J Korean Orthop Assoc.  2008 Oct;43(5):643-650. 10.4055/jkoa.2008.43.5.643.

Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients

• Hur CI
• Yoon TR
• Park KS
• Cho SG
• Yim JH

• KMID: 2186428
• DOI: http://doi.org/10.4055/jkoa.2008.43.5.643

Abstract

PURPOSE: The purpose of this study was to evaluate the short term follow-up results of minimally invasive (MI) two-incision total hip arthroplasty (THA) for treating acute displaced femoral neck fractures in active elderly patients.
MATERIALS AND METHODS
We performed a retrospective review of 39 cases (average age: 72 years old, range: 60 years and above) of elderly patients who underwent MI two-incision THA within 30 days of their injury for treating displaced acute femoral neck fractures. They were followed up for a minimum of 12 months. Clinical evaluation was done by comparing the pre-injury and postoperative daily activities, the Harris Hip score (HSS) and the Western Ontario and McMaster University (WOMAC) score. The radiographs were checked to evaluate for implant alignment and periprosthetic abnormalities. The postoperative complications were analyzed.
RESULTS
The average postoperative HSS was 88.3 and the average WOMAC score was 28.8. All the patients were able to walk without any assistive device. One patient had a HHS of less than 70. There were 2 dislocations but there was no recurrence. Radiographically, there was no case with a limb length discrepancy of more than 5mm. The femoral stems did not reveal any subsidence of more than 5mm. Other complications such as osteolysis, infection, neurologic injury and intraoperative periprosthetic fracture were not noted. Especially, no patient complained of any groin pain, which often occurs after bipolar hemiarthroplasty.
CONCLUSION
The short term follow-up results were good for MI two-incision THA to treat acute displaced femoral neck fractures in active elderly patients, and these procedures were done by an experienced hip surgeon.

Keyword

Hip joints; Femoral neck fracture; Total hip replacement; Minimally invasive

MeSH Terms

Aged
Arthroplasty
Arthroplasty, Replacement, Hip
Dislocations
Extremities
Femoral Neck Fractures
Femur Neck
Follow-Up Studies
Groin
Hip
Hip Joint
Humans
Ontario
Osteolysis
Periprosthetic Fractures
Postoperative Complications
Recurrence
Retrospective Studies
Self-Help Devices
Tacrine
Tacrine

Figure

• 

  Fig. 1 (A) The radiographs of a 78-year old male show a Garden stage IV fracture of the left femur neck. (B) We performed minimally invasive two-incision THA. (C) The radiographs 1 year 10 months after THA show good bone ingrowth. His HHS was 89 and the ADL scale was 1.

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