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FIRST YEAR MORTALITY AND LONG-TERM FUNCTIONAL RESULTS OF THOMPSON HEMIARTHROPLASTY FOR FEMORAL NECK FRACTURES IN THE ELDERLY

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Hip fractures are injuries that affect not only the joint of an elderly person, but also the patient’s survival. Four surgical options are well supported in the orthopaedic literature: reduction with internal fixation, different types of unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty.

The aim of this study is to assess Thompson hemiathroplasty as a treatment for these lesions and their complications. Between January 1999 and September 2003, we treated 213 patients who suffered femoral neck fracture, 119 patients of them were treated with Thompson cemented prosthesis. The average age was 82.6 years. The average time between admission and surgery was 3.1 days. The time between surgery and discharge from hospital was 7 days on average. First year mortality after fracture was assessed (25%) and functional results were compared with the preoperative status. The mean follow-up was 36 months. Independence in daily activities before and after fracture compared according to a modified scored questionnaire, based on the lower extremity measure, which was easy to administer by telephone interview. Of the 96 patients that we contacted 48 were alive and available for follow-up. 11 patients (11.4%) had clinical and surgical complications. According to functional results 28.5% of the patients reached a score between 85 and 99 points (very good), 40.8% had a score between 55 and 84 points (good) and 18.4% had a fair outcome in postoperative time.

We consider that Thompson hemiarthroplasty must remain as a surgical option in the treatment of femoral neck fractures in the elderly. The procedure provides rapid return to preoperative functional status for the majority of the patients (71.3% in the present study) with low surgical cost.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.