Primary total hip arthroplasty for displaced femoral neck fracture.
Total hip arthroplasty (THA) for displaced femoral neck fracture has potential advantages over open reduction/internal fixation and hemiarthroplasty. Thirty-seven patients who underwent THA for displaced femoral neck fractures between June 1993 and June 2005 were evaluated, and the exact head/neck ratios were calculated by the prosthesis manufacturers. The major complication rate was 16.1% (6 of 37) with 5 dislocations (all with surgery prior to 2002) and one nonfatal myocardial infarction. One- and 2-year mortality was 2.7% (1 of 37) and 8.1% (3 of 37), respectively. A smaller head/neck ratio (P=.002) in patients who dislocated was observed. The optimal head/neck ratio was =/>2.13. Total hip arthroplasty for displaced femoral neck fracture allows patients to return to most preinjury activities. In order to avoid dislocation, constructs with a larger head/neck ratio should be used.
Watson
David
D
Hospital for Special Surgery, 535 E 70th St, 3rd Fl, Room 324, New York, NY 10021, USA.
Bostrom
Mathias
M
Salvati
Eduardo
E
Walcott-Sapp
Sarah
S
Westrich
Geoffrey
G
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000601:surgery*; D006617:Hip Dislocation / Q000175:diagnosis / Q000209:etiology*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome