Abstract :
Background: The fracture neck of femur is one of the commonest fractures in elderly. With life expectancy
increasing with each decade, our society is becoming increasingly an active geriatric society, with significant
number of hospitalized and nursing home patients with femoral neck fractures and their sequelae. Selection
of the type of prosthesis is very important in hemiarthroplasty as different types are available. Since the last
two decades, bipolar replacements of the femoral head have gained popularity for treating femoral neck
fractures. Aim & Objective – To assess and analyse the results of management of fracture neck of femur with
bipolar hemiarthroplasty. Methods: After obtaining ethical committee approval and informed consent from
patient, detailed history of patient was taken with particular emphasize on mode of injury and associated
medical illness. On the day of surgery , under anesthesia and patient in lateral position, following strict
aseptic precautions, either lateral (Hardinge) or Posterior (Southern-Moore) approach incision made, tissues
dissected, joint capsule incised and femoral head extracted with the help of cork screw. Then the appropriate
size of prosthesis with cement was seated. The wound was closed meticulously in layers. Knee flexion,
isotonic quadriceps exercises were started from 1st or 2nd post op day and patients were mobilized with
walker as tolerated. Patients are educated on different position of legs that should be avoided in the postoperative
period. Follow up was done after 6 weeks and for further at 3 months, 6 months & 1 year .Result:
In our series, at the end of final follow-up, there was no evidence of loosening, radiolucent zones, distal
migration or subsidence of prosthesis. The patient with Periprosthetic fracture healed and is weight bearing
fully with no pain. One patient who had moderate heterotopic ossification had still has some mild pain
occasionally. Conclusion: we conclude that bipolar hemiarthroplasty produces good functional outcomes
with minimal complications for displaced intracapsular femoral neck fractures and has several advantages;
these results are comparable to the other studies.
Keyword :
fracture neck of femur, bipolar prosthesis, bipolar hemiarthroplasty, Harris hip score.