Invention technique and clinical results of Lampang cement injection gun used in hip hemiarthroplasty.
BACKGROUND
Cemented hemiarthroplasty is the common treatment of femoral neck fracture in elderly patients. The authors had invented Lampang cement gun (LCG) from a caulking gun to improve cementing technique. There was no previous study about LCG in clinical use.


OBJECTIVE
To describe invention technique and evaluate clinical result of using LCG for cemented hemiarthroplasty in elderly patients with femoral neck fracture.


METHODS
A retrospective study was conducted on 96 elderly patients who underwent cemented hemiarthroplasty (58 Austin Moore, 14 Thompson, 24 bipolar) in Lampang Hospital between October 2003 and April 2008. The femoral canal was filled with cement by using LCG Clinical outcome was assessed by Harris hip score (HHS). Radiographic quality of cementing technique was evaluated by Barrack's grading system.


RESULTS
The mean age of the patients was 76 years (range, 62-96) and follow-up period was 39 months (range, 12-66). Twenty-four patients died and five were lost to follow-up. The mean HHS in bipolar group was higher than Thompson and Austin Moore groups (83.2, 78.3 and 76.9 respectively). Excellent and good scores were found in 90.9% of bipolar hips compared with 46.7% in unipolar hips. Less than 10% of the patients had poor clinical result. Cement mantles was grade A 37.3%, B 32.8%, C 20.9% and D 9%. Probably loose was found in one grade-D hip. Two grade-D hips were removed due to infection and dislocation. One grade-C hip was revised due to periprosthetic fracture. The mortality rate at 36 months was 20.8% in unipolar and 8.3% in bipolar group.


CONCLUSIONS
The use of LCG for cemented hemiarthroplasties in elderly patients with femoral neck fracture provided satisfactory clinical outcome. LCG could be used to improve cementing technique and save the operative cost.
Pongkunakorn
Anuwat
A
Department of Orthopaedic Surgery, Lampang Hospital and Medical Education Center, Lampang, Thailand. dranuwat@gmail.com
Thisayukta
Phornphinit
P
Palawong
Pattanapong
P
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements / Q000009:adverse effects; D002484:Cementation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
D001843:Bone Cements