Authors: Tuteja Sanesh V, Mansukhani Sameer A, Mukhi Shyamlal R
Rationale: Internal fixation is considered a reliable method for an undisplaced intracapsular fracture and also for displaced intracapsular fractures in young patients. A unipolar or bipolar hemiarthroplasty is preferred for these fractures in elderly patients with low functional demands. However, controversy exists regarding the choice of prosthesis in patients with displaced intracapsular femoral neck fractures in relatively young and active adults. Design: 45 patients with displaced intracapsular femur neck were randomized to undergo a Total hip arthroplasty or a Bipolar hemiarthroplasty. The outcome was assessed with the use of the Harris hip score and the Mobility score of Parker and Palmer. Results: The mean age of the patients was 63.54 years. The mean blood loss was higher in Group 2 (THA) [545.24 ±134. 07 ml] as against Group 1 (BH) [443.75± 88.84 ml] (p= 0.004). The mean duration of surgery in Group 2 [121.90 ±20. 40 mins] was significantly higher as compared to that in Group 1 (BH) [87.50 ±10. 52 mins]. No significant difference was observed in the mean postoperative Mobility Score at the end of 6 months amongst the 2 groups. The Harris Hip Score at the end of 6 months was Excellent for 9 patients, Good for 27 patients, Fair for 6 patients and Poor for 2 patients. 40 patients were able to do their daily activities and 4 were unable to do so owing to their general medical condition. Conclusion: Total Hip Arthroplasty offers better functional outcome in early follow-up and can be used for treating for these fractures in this age group.
Key words: Bipolar Hemiarthroplasty, Total Hip Arthroplasty, Fracture Neck Femur, Proximal Femoral Fracture.