Austin-moore hemiarthroplasty; the Enugu experience.
BACKGROUND
Femoral neck fracture is the commonest fracture among the elderly who frequently have co-morbid medical conditions. It commonly follows trivial falls at home. Prosthetic replacement with Austin Moore prothesis is one of the treatment options open to Orthopaedic Surgeons in this age group who need to be mobilised as early as possible to prevent the complications of prolonged immobilization. This study shows our experience with Austin Moore hemiarthroplasty [AMH] as a treatment option for femoral neck fractures over a 10 year period.


METHODS
Hospital records of 46 out of 59 patients who had AMH in NOHE between 1995-2004 (10 year period) were reviewed retrospectively. The 13 patients who had incomplete records were excluded.


RESULTS
The age range of the patients was 26-99 yrs with 67:2 yrs as the mean. There was a slight female to male preponderance [F:M = 1.1:1]. Most of the patients clustered between 61 and 80yrs. Majority presented late [76%], with only 2 patients presenting within 24hrs of injury. Fracture neck of femur was the commonest indication for AMH [89.1%] with domestic falls and RTA having 54.3% & 32% respectively as aetiological factors. Hypertension was the most prevalent co morbid medical condition [76%]. Majority of the patients had preoperative traction, 58% (skin: 32.6%, skeletal 26.1%) while general anaethesia was used in 63% of patients. Blood transfusion was common; 87.1. 58.7% of patients were mobilized within 2-3 wks of operation while 26.9% were delayed for more than 3 wks. 2 patients [4.3%] died while on admission. 76.1% were mobilized initially on Zimmer frames, 13.0% on crutches, 6.5% on wheel chair. 80% were able to walk with walking stick[cane] in 6 weeks while 87% achieved this in 12 weeks. Follow up time of patients was poor as patients default frequently after few visits. Wound infection was the commonest complication 26.1%, mostly treated by dressing and antibiotics. 13.0% were hospitalized for 2-3 weeks, 36%-4-6 wks while 50% stayed beyond 6 wks. Mortality rate was 4.3% [2].
Eyichukwu
G O
GO
National Orthopaedic Hospital, Enugu, Nigeria.
Iyidobi
E C
EC
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011183:Postoperative Complications; D012307:Risk Factors; D016896:Treatment Outcome