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- Bipolar Hemiarthroplasty for the Femur Neck Fractures in Patients Aged Around Ninety
- Hyung Ku Yoon, Duck Yun Cho, Dong Eu Shin, Jae Haw Kim, Jin Soo Lee, Jae Hyung Kim
- J Korean Fract Soc 2004;17(3):209-213. Published online July 31, 2004
- DOI: https://doi.org/10.12671/jkfs.2004.17.3.209
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Abstract
PDF - PURPOSE
To evaluate the functional changes, postop delirium and complications after cemented bipolar hemiarthroplasty for the femur neck fractures in patients aged around ninety.
MATERIALS AND METHODS
Between May 1995 and April 2002, of the twenty seven patients, 17 who follow-up for at least one year were included in this study. Walking ability, activity of daily living, mental status, chronic illness, postoperative delirium and complications were evaluated retrospectively using Yoon's walking class, ADL scale, MMSE-K score, ASA classification, DSM IV respectively.
RESULTS
The walking ability was decreased to 2.4 from 3.3 tendency of reliance in ADL scale was increased to 8.3 from 4.5, MMSE-K score was decreased to 15.9 from 21.7. There was no significant change in status of chronic illness. Postoperative delirium occurred in eight (47%) cases and all of them recovered completely. complications included bladder problem in eleven (66%) cases, temporary respiratory distress in two (12%) cases, hip dislocation in two (12%) cases, infection in one (6%) case. Overall thirteen (78%) cases were able to walk with supports.
CONCLUSION
This study indicates that physicians treation femur neck fractures in patients aged around ninety must anticipate worsening of the functional changes more especially in regard to walking level, activity of daily living and mental status, little changes of chronic disease status, complete recovery of postop delirium and high complication rate
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- Treatment of Femoral Neck Fractures in the Elderly Patients Aged over 60 years: Comparative Study between Osteosynthesis and Bipola Arthroplasty
- You Sung Suh, Byung Woo Kim, Kyung Dae Min, Chi Soo Son, Soo Kyoon Rah, Chang Uk Choi
- J Korean Soc Fract 1998;11(1):153-158. Published online January 31, 1998
- DOI: https://doi.org/10.12671/jksf.1998.11.1.153
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Abstract
PDF
- STUDY DESIGN: Seventy femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary biploar arthroplasty were assessed on complication and functional outcome at final follow up.
OBJECTIVE: To compare the results of femoral neck fractures in the elderly patients aged over 60 years treated with osteosynthesis or primary bipolar arthroplasty retrospectively. To know the indications of each method.
SUMMARY OF BACKGROUND DATA: Althrough the osteosynthesis method had preservation of hip joint, primary osteosynthesis method had possibility of major complications as nonunion and avascular necrosis of femoral head.
METHODS
Seventy patients with intra-articular femoral neck fracture were treated with osteosynthesis in 33 patients(group 1) and primary biploar arthroplasty in 37 patients(group 2). A comparartive analysis of age, sex, type of fracture, initial displacement of fracture, method of treatment, fixation device type, quality of reduction, operative time, blood loss at operation, complication and functional outcome at final follow up were performed.
RESULTS
The female was more three times than male. The mean ages were 70.1 years old in group 1 and 73.3 years old in group 2. In group 1, complications such as non-union and avascular necrosis of femoral head were significantly greater in the subcapital fractures and Garden's stage 3,4 than the transcapital fractures and Garden's stage 1,2. In operative method, blood loss and operative time were significantly greater in the group 2 than in the group 1. Seven major complications (avascular necrosis: 6 cases, non-union: 1 case) occurred in group 1, two major complications(death: 2 cases) occurred in group 2. The functional outcomes were superior to the group 2, but it may be due to high complication rates in group 1.
CONCLUSIONS
This study suggests that the important factors that influenced the clinical results were type of fracture, initial displacement of fracture, quality of reduction. So in relatively poor arthroplasty.
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