The Result of Total Hip Arthroplasty after Failure of Multiple Screw Fixation for Femoral Neck Fracture

Min-Cheol Kim; Kyung-Soon Park; Taek-Rim Yoon

doi:10.4055/jkoa.2015.50.4.280

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Kim, Park, and Yoon: The Result of Total Hip Arthroplasty after Failure of Multiple Screw Fixation for Femoral Neck Fracture

Original Article

Journal of the Korean Orthopaedic Association 2015; 50(4): 280-289.

Published online: 24 August 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.4.280

The Result of Total Hip Arthroplasty after Failure of Multiple Screw Fixation for Femoral Neck Fracture

Min-Cheol Kim, M.D., Kyung-Soon Park, M.D., Ph.D., Taek-Rim Yoon, M.D., Ph.D.

Department of Orthopaedic Surgery, Chonnam National University Medical School, Gwangju, Korea.

Correspondence to: Taek-Rim Yoon, M.D. Department of Orthopaedic Surgery, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. TEL: +82-62-220-6002, FAX: +82-62-225-7448, tryoon@chonnam.ac.kr

Received 3 March 2014 Revised 8 October 2014 Accepted 30 March 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to analyze the result of secondary total hip arthroplasty (THA) after primary internal fixation failure in femoral neck fracture patients and compare the results with primary THA for femoral neck fracture.

Materials and Methods

Among the femoral neck fracture patients, we analyzed clininal and radiologic results of those who underwent secondary THA after internal fixation failure and those who underwent THA as early treatment. Cases with patients over age 40 years and with at least two year of follow-up period were used for analysis. Periopertive conditions of patients were evaluated by using surgery time, bleeding amounts and period to start gait using walker or crutch after surgery. Clinical results were assessed by using Harris hip score and Western Ontario and McMaster Universities Osteoarthritis Index, and radiologic results were derived by observing follow-up simpe X-ray.

Results

The group of secondary THA had longer surgery time, more bleeding amount and longer period to start gait. But between the two groups, there was no difference of clinical and radiologic result at final follwing up. Both of two group had excellent clinical and radiological results.

Conclusion

THA after internal fixation showed excellent clinical and radiologic results that was comparable to compare with primary THA.

Keywords: femoral neck fractures, post-traumatic avascular necrosis of the femoral head, fracture nonunion, total hip arthroplasty

Figures and Tables

Figure 1

A 73-year-old female patient with right femur neck fracture. (A) Preopertive radiograph. (B) Immediate postoperative radiograph after primary total hip arthroplasty. (C) Final follow-up at 2 years.

Figure 2

A 64-year-old male patient with right femur neck fracture. (A) Preopertive radiograph. (B) Postoperative radiograph after screw fixation at local hospital. (C) Radiograph after 4 month, screw fixation failure. (D) Postoperative radiograph after screw removal and secondary total hip arthroplasty. (E) Final follow-up at 2 years.

Table 1

Implant Materials of THA

THA, total hip arthroplasty; IF, internal fixation; fx, fracture

Table 2

Demographics of the Patients

Values are presented as number only or median (range). THA, total hip arthroplasty; IF, internal fixation; fx, fracture; M, male; F, female; BMI, body mass index; ADL, activities of daily living.

Table 3

Comparison of the Perioperative Parameters

^*Statistically significant difference. THA, total hip arthroplasty; IF, internal fixation; fx, fracture; H/V, Hemo Vac drainage.

Table 4

Functional Status in Patients at Last Follow-Up

Values are presented as mean±standard deviation. THA, total hip arthroplasty; IF, internal fixation; fx, fracture; HHS, Harris Hip score; ROM, range of motion; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.

Table 5

ADL Scale of Pre-Injury and Last Follow-Up

ADL, activities of daily living; THA, total hip arthroplasty; IF, internal fixation; fx, fracture.

Table 6

Perioperative Complications of the Hip Arthroplasties

THA, total hip arthroplasty; IF, internal fixation; fx, fracture; UTI, urinary tract infection; GI, gastrointestinal.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclos

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