Abstract
Aim: To identify the significant risk factors that influence patient mortality and morbidity in the management of displaced subcapital neck of femur fractures in independent elderly patients (aged > 70 years) managed with total hip arthroplasty through a modified Hardinge approach.
Methods: Thirty-seven primary hip arthroplasties performed for displaced fractures of the neck of femur in “Healthcare Hawkes Bay” between 1998 and 2000 were reviewed. The surgery was carried out by one surgeon (VP), using a modified lateral approach. The patients’ records were screened for outcomes and complications. An independent review was made (DA, NW) using the modified Harris hip score.
Results: The average age of the patients was 85 years (range: 70 to 92 years). At an average of 1.8 years (12 months to 24 months), no patient had suffered a dislocation or had needed another operation on the hip. The majority of the patients were satisfied with the outcome. However, there were significant medical complications (total of 38 complication in 22 patients). There were two deaths in the first 12 months.
Conclusions: The incidence of dislocation and a reduced revision rate can be achieved with a modified lateral approach (Hardinge). However, aggressive treatment is necessary before and after the surgery, as there is high incidence of medical complications. The number of existing medical conditions at the date of admission to hospital was a significant factor influencing patient morbidity.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
