Abstract
Purpose: We will present our experience regarding sub-capital femoral fractures that were treated by cemented bipolar hemiarthroplasty with Chanley stem during the years 1987 to 2002.
Method: We treated 159 patients with subcapital femoral fractures, type Garden stage 3 and 4. Of those 57 were men and 102 women aged between 65 and 85 years old. All the patients underwent surgical treatment by the same surgeon team, using cemented bipolar hemi-arthroplasty Hastings types, with Chanley stem. The preferred surgical approach was the anterolateral with partial incision of the gluteus medius muscle and preservation of the posterior capsule of the hip joint, so that the prosthesis would be stable and the abductor muscles retained their strength.
Results: The observation time ranged from 6 months to 15 years. During this period 38 patients passed away and 24 never returned for follow up. The observed complications were: 1 aseptic loosening of the femoral stem that was dealt with THA, 1 superficial inflammation that was taken care of with surgical cleaning and antibiotic administration and 1 dislocation of the metal cup (with the internal polyethylene bearing) from the femoral stem that was corrected by OR. Postoperative hip mobility was found to be excellent (62%), fair (32%), poor (6%). 6 patients reported light to moderate pain during walking. We observed that the dual motion of the bipolar prosthesis is considerably reduced and eventually disappears over time.
Conclusions: From our long time experience regarding subcapital femoral fractures types Garden 3 and 4 in patients aged between 65 and 80 years old, we believe that the cemented bipolar hemiarthroplasty is a very good method of choice.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
