Mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty.
OBJECTIVE
To determine mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty (Austin Moore Prosthesis) during one year postoperatively.


METHODS
Descriptive, analytical study.


METHODS
Department of Orthopaedics, Postgraduate Medical Institute/Hayatabad Medical Complex, Peshawar, from June 2001 to May 2002.


METHODS
During the study period, all patients with fracture neck of femur, who were 65 years of age or above and treated by Austin Moore Prosthesis (AMP), were included. The patients were followed for one year at intervals of 2 weeks, 4 weeks, 6 months, and one year. All surviving patients were assessed for complications, both general and mechanical, related to the implant. The mortality and morbidity were compared for various age subgroups, and in patients with and without systemic co-morbidities.Chi square test was applied to see the significance of results.


RESULTS
The total number of patients was 46 with average age of 70 years. Male to female ratio was 1:2. There were 70% patients who had one or more associated systemic disease. The mortality at 2 weeks was 4.3%, 17.4% at 6 months and 26% at one year. The overall dislocation rate was 4.3%. Two patients had infection and 17.4% patients had thigh pain at one year. The mortality and morbidity was high in patients with systemic co-morbidities, and those above 70 years of age, but this was statistically not significant (p value >0.05). The functional assessment of surviving patients at one year was graded as excellent or good in 76.4% of patients.


CONCLUSIONS
In this series, Austin Moore Prosthesis in elderly patients was associated with dislocation, infection and thigh pain in short-term follow-up. The postoperative mortality was high, but it was age and systemic co-morbidity-related rather than due to the surgical procedure. The functional assessment of hip at one year was excellent or good in majority of surviving patients.
Ahmad
Israr
I
Department of Orthopaedics and Trauma, Khyber Teaching Hospital, Peshawar. israr_3@yahoo.com
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D005264:Femoral Fractures; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D009017:Morbidity; D016896:Treatment Outcome