A RETROSPECTIVE COHORT STUDY COMPARING RADIOLOGICAL AND FUNCTIONAL OUTCOMES OF VARIOUS TREATMENT OPTIONS FOR UNSOLVED FRACTURES IN THE ELDERLY: A STUDY OF FEMORAL NECK FRACTURES.

Mohammad  Ekram

doi:10.51168/sjhrafrica.v5i3.1143

Authors

Mohammad Ekram MS Orthopedic, Department of Orthopedic, Madhubani Medical College, Madhubani, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1143

Keywords:

Femoral Neck Fractures, Treatment Options, Total Hip Arthroplasty, CC Screw Fixation

Abstract

Background:

Femoral neck fractures in the elderly present a significant clinical challenge, requiring effective management strategies to optimize outcomes. This study aimed to evaluate and compare the radiological and functional outcomes of different treatment options for unsolved femoral neck fractures in the elderly population.

Methods:

A retrospective cohort study design was employed over 24 months. Sixty participants meeting inclusion criteria underwent treatment for intracapsular femoral neck fractures. Demographic data, radiological findings, surgical techniques, and postoperative outcomes were collected and analyzed. Statistical analysis was conducted to compare outcomes between treatment groups.

Results:

The average age was 74.5 years, with a majority being female (66.7%). Treatment modalities included cemented bipolar hemiarthroplasty (41.7%), CC screw fixation (33.3%), and total hip arthroplasty (25.0%). Radiological assessments demonstrated satisfactory fracture reduction in 80% of participants undergoing cemented bipolar hemiarthroplasty, 75% in the CC screw fixation group, and 90% in the total hip arthroplasty group. Total hip arthroplasty showed superior functional outcomes, with higher Harris Hip Scores (HHS) and Modified Barthel Index (MBI) scores compared to other modalities. Complication rates were lowest in the total hip arthroplasty group (12%).

Conclusion:

Total hip arthroplasty emerged as the preferred treatment modality for unsolved femoral neck fractures in the elderly, offering superior radiological and functional outcomes with lower complication rates compared to cemented bipolar hemiarthroplasty and CC screw fixation.

Recommendations:

Clinicians should consider total hip arthroplasty as the primary treatment option for intracapsular femoral neck fractures in elderly patients, based on the findings of this study.