Abstract: Background: A basicervical femoral neck fracture, which is located at the junction between the femoral neck and intertrochanteric region, is a rare type of fracture. (1) Despite several randomized trials and comparative studies treatment of unstable basicervical fractures in elderly patients is still controversial, which we want to investigate.
Methods: A prospective cohort analysis of 44 patients, of which 22 each were operated with cemented bipolar hemiarthroplasty (BPA) and proximal femur nail (PFN) between January 2018 till July 2021 was done. Primary outcome was assessed in both groups using Harris hip score( HHS) at 4weeks, 6 weeks, 12weeks, 6months and 1 year on outpatient basis. The secondary outcome measures were intraoperative blood loss, surgical time, functional outcome, range of motion limb length discrepancy at final follow up. All complications were noted at follow up.
Results: The HHS was significantly higher for BPA group at all follow ups, at 4 weeks of follow up was 79.81 for BPA and 73.18 for PFN (p-value = 0.001) and at 1 year of follow up was 88.55 for BPA and 79.03 for PFN (p-value = 0.001). Statistically significant differences were found between BPA and PFN groups with reference to intraoperative blood loss, surgical time, functional outcome, range of motion, limb length discrepancy at final follow up.
Conclusion: The bipolar hemiarthroplasty group had fewer complications and earlier mobilization with better Harris hip score at all follow ups, which indicate bipolar hemiarthroplasty is a better option in the treatment of unstable basicervical fractures in elderly patients.
