Abstract
This study was undertaken to determine the most effective way of treating intracapsular femoral neck fractures in HIV-positive patients. Ten patients with a mean age of 36 years were treated. Excision Girdlestone was performed In three patients in whom previous internal fixation had failed: all had poor nutritional status and low CD4 counts (mean 162). Three patients with undis-placed fractures were treated with percutaneous AO screws and a dynamic hip screw. In the remaining four patients, total hip arthroplasty (THA) was performed. At a mean follow-up of 14 months, all patients were fully ambulant with no signs of infection.
The decision to proceed with THA in HIV-positive patients should be made only after weighing the ratio of risks and benefits. The ultimate outcome depends on a number of factors, including displacement of fractures, previous surgery, co-existent medical problems, nutritional status and the stage of the disease.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
