[THR in Osteoporotic Fractures of the Femoral Neck.].
The authors present a group of 49 patients with a fracture of femoral neck with the symptoms of evident osteoporosis treated by THR. The group comprised 44 females and 5 males, average age 70 years (62-88 age range). Tha authors evaluated 42 patients on average 18 months after the surgery (9 to 29 months). Indicated to THR were 36 acute fracteures and 13 early failures of fixation. The degree of osteoporosis after Singh: grade 4-4 patients, grade 3-22 patients, grade 2-19 patients, grade 1-4 patients.The type of fracture after Garden: type II - 5, type III - 26, type IV - 18 fractures. The authors used in 39 patients (Singh 1-3) the cemented type of THR with polyethylene cup, in 6 of which they reinforced the acetabular cup with a metal ring (Eichler, Miiller). In 4 cases they used a hybrid type of THR with Spotorno cup (Singh - 4). They applied the cementing technique of 2nd generation. Forty-five patients evaluated their condition after operation as very good or good, 38 patients were equally active as before the operation, 44 reported a good range of motion. Harris average score was 88 (75-99). In one female patient the authors found a deep infect. In 41 patients (of 42 evaluated) firm osteointegration of both components was achieved. The authors indicate total replacement in active patients with dislocated fracture of femoral neck and osteoporosis Singh 4-1 older then 62 years. They prefer it to internal fixation in order to avoid known complications. They refer to good results of their group of 84 total replacements evaluated during the average period of 5,5 years (from 1981-1986) and to the extensive recent study of the Mayo Clinc. Key words: fracture of femoral neck, THR.
Rozkydal
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Z
I. ortopedická klinika MU, FN U Sv. Anny, Brno.
Hart
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R