Abstract: Introduction: Fractures of the upper extremity of the femur (EFSF) occur by far, most frequently in the elderly and are the most serious because of their morbidity, mortality and their economic impact. Partial joint arthroplasty (PIH) is a solution of choice for the management of femoral neck fractures. The objective of our study was to analyze the therapeutic results after monobloc hip joint arthroplasty.
Material and Methods: This ag it a bi-center retrospective study from January 2014 to June 2017. A total of 125 cases were identified in 73 women and 52 men with a mean age of 68 years +/- 10,12. The average time between the first consultation and the surgery was 12,30 days (extreme: 2- 548 days). The etiologies were dominated by falls (72,2%). The study parameters were the therapeutic data (recent fracture or nonunion, type of anesthesia, approach, type of implant, possible intraoperative complications) and postoperative anatomo-radiological data (stem orientation, femoral offset, ILMI, seal quality, possible complications and functional assessment according to the PMA score).
Results: There were 96 recent fractures and 29 nonunions. The approach was transgluteal (86 patients) and postero-external (39 patients). Prosthesis sizes 46 and 48 were the most used. Cemented stems represented 87, 2% of cases. In intraoperative 5 trochanteric cracks, 1 acetabular fracture and one wrong were noted. A node earner decrease (mean 16.3 months for extremes of 6 and 42 months), 76% of the stems were medialized against 9% lateralized. The femoral offset was restored in 32%, increased in 36% and decreased in 32% of cases. The lower limbs were iso-equal in 37.6% of cases and an ILMI equal +/- 1cm in 62.4% of patients. Sealing was good in 89%. We observed 20.8% of cases of lameness, 4% of cases of early dislocation, 3.2% of cases of loosening. According to the PMA rating, our results were satisfactory in 74.4% and bad in 7.2%.
Conclusion: In view of our results, PIH ensures, in the short and medium term, satisfactory functional results. A mastery of the technique and a rigor in its realization must make it possible to ensure a satisfactory survival of the implant.
