FEMORAL NECK FRACTURES TREATED WITH HEMIARTHROPLASTY: FUNCTIONAL OUTCOMES USING VALIDATED MEASURES (PRELIMINARY RESULTS)

Abstract

The primary objective of this study was to report the progression of functional status over time after hemiarthroplasty surgery for displaced femoral neck fractures in one hundred patients. One of the secondary outcomes was to determine factors predictive of bad outcome (age, co-morbidities, type of anesthesia, surgical approach, etc). Another secondary objective was to determine if early functional assessment correlates and/or predicts long term function. Finally, our group was compared to a normal control group database.

A hundred patients treated with hemiarthroplasty for Garden-type III and IV femoral neck fractures were evaluated prospectively using validated functional outcome measures. Baseline data and preoperative functional level was determined for all patients. Functional recovery was evaluated using the Lower Extremity Measure (LEM) and the Time Up and Go (TUG). Clinical outcome was equally measured using the Harris Hip Score and SF-36 (Short-Form 36). Follow-up was done at one and a half, three, six, nine, twelve and twenty-four months.

Preliminary results show that this study group is comparable to the group used in Jaglal et al.’s original study of the Lower Extremity Measurement score. LEM scores at one year follow-up are significantly lower than pre-operative scores. TUG scores at three months follow-up were significantly lower in the female sub-group in comparison to normal controls.

This study of patients undergoing hemiarthroplasty for femoral neck fractures demonstrates the significant post operative functional repercussions as shown by the deterioration of scores of functional outcome measures used. Predicting functional outcomes based on pre-operative patient baseline data and function is relevant in that it could potentially impact decision to operate and determination of surgical procedure of choice.