A hip fracture is a break that occurs in the upper part of the femur and the symptoms may include pain around the hip particularly with movement and shortening of the leg. Usually the person cannot walk. They most often occur as a result of a fall. Risk factors include osteoporosis, taking many medications, alcohol use, and metastatic cancer. Intracapsular fractures of the proximal femur account for a major share in the community and have a tremendous effect on both the health care system and society in general. Despite the marked improvements in surgical interventions, treatment of fracture neck of femur since then remains a debate, especially in the elderly.
Materials and methods: Twenty cases of fracture neck of femur in elderly patients of age 60 years and above treated by hemi-arthroplasty using cemented bipolar prosthesis. Inclusion criteria employed was 1) Intra-capsular fracture neck of femur in patients of age 60 years and above, 2) Un-united fracture neck of femur, 3) Fracture neck of femur with avascular necrosis.
Results: At the end of 6 months after surgery, the functional results are analysed in 20 cases. All patients were in the age group of 60 to 82 years with mean average age of 75 years. 35% of the patients had a Garden type III fracture radiologically, while 60% had a Garden type IV and 1 patient was diagnosed with a non union fracture neck of femur. In 75% percent cases the mode of injury was trivial trauma. Associated medical conditions like hypertension, diabetes mellitus and heart disease or a combination of these were seen in 11 patients. Some of the complications observed were superficial infection of the wound or a limb length discrepancy, following the procedure. There were 50% excellent results and 30% good results.
Conclusion: The success of hemiarthroplasty no doubt depends on preoperative planning and proper attention to surgical details to achieve the optimum biomechanical stability. This study showed that the final functional outcomes were dependent on the presence of associated co-morbidities and the optimum post operative rehabilitation of the patient following surgery.