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Displaced intracapsular neck of femur fractures: dislocation rate after total hip arthroplasty

Includes bibliographical references / Background: Dislocation is one of the most common orthopaedic complications after primary total hip arthroplasty (THA). The reported dislocation rate in elective THR is 5 - 8%. This number increases up to 22% for THA done for neck of femur fractures. Larger femoral head sizes increase the head-neck ratio and range of motion before impingement, therefore reducing the dislocation rate. Due to the reported increase in dislocation for trauma, some surgeons prefer to do a hemi-arthroplasty or open reduction and internal fixation (ORIF). Methods: A retrospective review of all THA done for neck of femur fractures during 2006 - 2012 was undertaken at a large referral hospital. Records were reviewed for patient related and surgical risk factors. We excluded all pathological fractures, extra-capsular fractures and failed ORIF. Results: A total of 96 cases were identified as suitable for analysis. Average age at surgery was 73.2 years (range 30 - 81). Delay to surgery was 5.3 days (range 1 - 63). Average follow up period was 18.3 months (range 3 months - 4.3years). Four patients (4.3%) had a confirmed dislocation. The four patients who had confirmed dislocation had the following characteristics, 28 mm femoral head size, age over 60 years, 2 posterior approaches and 3 females, although not statistically significant. Conclusion: The outcomes of THR in patients with neck of femur fractures can be favourable and provide good long-term prosthesis survival. We report on low dislocation rate post total hip replacement for intra-capsular neck of femur fractures.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/16788
Date January 2015
CreatorsShituleni, Sibasthiaan Gometomab
ContributorsMaqungo, Sithombo
PublisherUniversity of Cape Town, Faculty of Health Sciences, Department of Health and Rehabilitation Sciences
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeMaster Thesis, Masters, MMed
Formatapplication/pdf

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