Abstract
Treatment of Displaced Intracapsular Hip Fractures with Charnley Hastings hemi-arthroplasty: Comparison of Primary hemi-arthroplasty with Early Salvage hemi-arthroplasty After Failed Internal Fixation
Heidi Nygaard Bakken and Torbjørn Mæhlum
Ullevål University Hospital, dept. of Orthopaedics
Faculty of Medicine, University of Oslo
BACKGROUND
Primary hemi-arthroplasty or closed internal fixation with nails or screws are the two main options for treating displaced fractures of the neck of the femur. Hemi-arthroplasty is also used for treating complications, i.e failure of osteosynthesis, pseudo-arthrosis and necrosis of the femoral caput. Only a few previous studies have compared the two methods in regards to the incidence of re-operations.
MATERIALS AND METHODS
All patients who received a Charnley Hastings hemi-arthroplasty were registered prospectively between January 1998 and March 2002. Of a total of 524 patients, 282 received a primary arthroplasty. 149 patients were operated with a secondary arthroplasty after failure of internal fixation with cannulated Olmed-screws.
RESULTS
The patients receiving secondary arthroplasty had a significantly higher re-operation rate and a relatively higher number of reoperations than the patients treated with primary arthroplasty.
CONCLUSION
In comparison with internal fixation, arthroplasty for the treatment of a displaced femoral neck fracture significantly reduces the risk of revision surgery.