Charnley-Hastings hemiartoplastikk ved disloserte lårhalsbrudd. En sammenlikning av primær hemiprotese versus hemiprotese sekundært til havarert skruefiksasjon. : en prospektiv registrering av 524 pasienter med lårhalsbrudd

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.