Abstract
The purpose of this study was to compare old and new techniques in hemiprosthesis for primary femoral neck fractures. We implemented a new technique for inserting the Charnley stem via the Hardinge approach. This included a distal centraliser, broaches and specific entry into the femoral canal via the piriformis fossa. We then compared stem alignment and cement mantle quality in old and new techniques. The sample comprised 42 patients (34 women) who had been operated on with the old technique and 49 patients (39 women) exposed to the modern technique.
Postoperative anteroposterior and true lateral radiographs were taken and evaluated for cementing quality, mantle thickness in the 14 Gruen zones and alignment of the femoral stem in both planes. On the Barrack classification there were nine grade-A with the new technique, compared to none with the old. There was one Grade-B with the old technique. With the new technique, cement mantle thickness and uniformity was better in Gruen zones 1 to 3, 5 to 10, and 12. Alignment as measured in the lateral plane by the mean antero-posterior angle was 5.2° with the old technique and 2.2° with the new (p =0.0001). In the frontal plane there was no difference.
It is hoped the advantages associated with this modern technique for inserting the Charnley stem will confer longer survival.
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.
