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[Femoral neck fractures in the elderly -- bipolar hemiarthroplasty in total hip replacement]
I Schleicher1, J Kordelle, I Jürgensen
1Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum Giessen, Paul-Meimberg-Str. 3, 35385 Giessen. iris.schleicher@ortho.med.uni-giessen.de
Introduction:
In this study surgical risk and functional outcome of bipolar hemiarthroplasty and total hip replacement in elderly patients with femoral neck fractures were compared.
Methods:
In a prospective study 54 patients with femoral neck fractures (median age: 80.5 years) were treated by implanting a total hip replacement (group I). Group II comprised 52 patients with 55 femoral neck fractures (median age: 81 years) who underwent bipolar hemiarthroplsty. Pre- and postoperative mobility and social history, perioperative parameters such as duration of surgery, blood loss, and number of transfused blood units as well as postoperative complications and mortality were compared. Function was ascertained by a scoring system.
Results:
Duration of surgery, blood loss, and numbers of transfused blood units were significantly lower in group II, and mortality rate was lower. Postoperative mobility and medium-term functional score were comparable, whereas in the longer-term follow-up after 8 years group I had a significantly better functional score.
Conclusion:
In elderly patients with femoral neck fracture and high comorbidity, we recommend the implantation of hemiarthroplasty and in healthy, active patients with longer life expectancy the total hip replacement.
