Clinical and radiological outcome analysis of neck of femur fractures treated with bipolar hemiarthroplasty: An Institutional study

Kalaiyarasan, T (2015) Clinical and radiological outcome analysis of neck of femur fractures treated with bipolar hemiarthroplasty: An Institutional study. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION: The neck of femur fracture is one of the common fractures in elderly. It has been always a challenge to the orthopaedic surgeons to manage these fractures. The prevalence of neck of femur fractures has increasing with increased incidence of osteoporosis, poor vision in elderly, poor neuro muscular coordination, life style changes, sedentary habits, improvement in life expectancy. The incidence is expected to be double in next twenty years, triple by 2050. The burden of neck of femur fractures and its sequelae continued to be on the rise. The treatment goal for this fractures is restoring of functions without morbidity, still controversy exists in management of neck of femur fractures in elderly. Open reduction and internal fixation in elderly has higher chance of non union & avascular necrosis. In 1974, bipolar prosthesis was introduced by bateman which had mobile haed element and had additional head surface to alow movement within acetabulum. This reduces the erosion in acetabulum and reduction in pain and incidence of protrusio. The motion occurs between metal head and polyethylene socket (inner bearing) as well as between metallic head and acetabulum (outer bearing). Unipolar prosthesis is used only in developing countries. It should be reserved for acive elderly and very limited patients. In india, bipolar prosthesis is slowly replacing unipolar prosthesis in elderly patients, because of the advantage of bipolar than unipolar like less post operative pain, good results, good range of movements & cost effectiveness. AIM OF THE STUDY: 1. To study the functional outcome of intracapsular fracture of femoral neck with bipolar prosthesis in Indian population. 2. To study the end results of bipolar prosthesis with respect to pain, mobility and stability. 3. To analyse the radiological parameters and bipolar mobility in fluorosocpy 4. To study the complications of bipolar hemiarthroplasty. MATERIALS AND METHODS: In this retrospective study, patients who underwent bipolarhemiarthroplasty for neck of femur fractures in Government Royapettah hospital was considered for the study Total number of cases : 34 Patients who came for follow up – 30 cases Inclusion criteria: 1. Patients who were treated with bipolar hemiarthroplasty 2. Age of patient > 60 years 3. minimum period of 2 years post op Methodology: The contact list of neck of femur fracture patients who were treated by bipolar hemiarthroplasty were obtained from medical records department. All the patients were communicated either thro’ letter or phone. A proforma were postulated, which after thorouh wetting by the guide was used for this study. All the patients were analysed uniformly with the same. All the patients were analysed in single visit. At the time of presentation all the patients analysed for 1. Functional outcome using modified hip score 2. Radiological assessment 3. Fluoroscopy analysis for interprosthetic movement Functional outcome: Modified harris hip score was used for analysis of the functional outcome for all the patients. OBSERVATION AND RESULTS: Out of 34 patients, only 30 patients came for the follow up. Data was collected with respect to history, clinical examination, radiological examination and fluoroscopy examination. The patients who have completed post op period minimum of 2 years included in the study. CONCLUSION: Bipolar hemiarthroplasty for fractures of the femoral neck provides freedom from pain and more rapid return to unassisted activity with an acceptable complication rate.  The end functional results depend on the associated co- morbidity and optimum post-operative rehabilitation.  There is no correlation between functional outcome and interprosthetic movements also radiological outcome.  Our study patients has good radiological outcome with significant interprosthetic movements, bipolar seems to be a cost effective prosthesis in active elderly individuals.  Similar study on long term follow up would provide more affirmative findings.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical and radiological outcome analysis ; neck of femur fractures treatement ; bipolar hemiarthroplasty ; institutional study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 25 Sep 2017 02:56
Last Modified: 25 Sep 2017 02:56
URI: http://repository-tnmgrmu.ac.in/id/eprint/3319

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