Abstract
The purpose of this study was to evaluate the outcome of internal fixation for undisplaced intracapsular fracture neck of femur in elderly group of patients with a view to evaluate the incidence of definitive procedure at a later date.
The method used for evaluation was retrospective study of 46 consecutive cases within one year, operated for Garden 1 or 2 type of fractures, who were followed up for upto 2 years. Postoperative complications, the need for further intervention and relationship with age and preoperative ASA grade was assessed.
Results of the study were quite interesting. 74% patients were above the age of 60 years. 60% of them (30 out of total 46) stayed in the wards for more then one week, due to medical problems. 35% (16 out of total 46) required further intervention in form of hemi-arthroplasty or total joint replacement, either due to implant failure or avascular necrosis. 63% of those who required further intervention 10 out of 16) were ASA grade 3 or above.
Conclusion of the study was that although internal fixation is a relatively small procedure, the complication rate, requiring further intervention was higher then anticipated. There is a role of primary definitive procedure in certain number of cases, specially those having higher anaesthetic risk i.e. ASA grade 3 or above.
Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
