Abstract
Introduction
Osteosynthesis to conserve femoral head following neck of femur (NOF) fractures has reported failure rates of 36 to 47% at 2 years. However, the long-term outcomes of THAs performed for failed osteosynthesis is yet to be elucidated. This study aims to report on long term outcome of primary THAs post failed osteosynthesis for NOF fracture.
Methods
Consecutive patients with THA for failed NOF osteosynthesis managed by a single unit between January 1974 and December 2009 were included. Clinical and radiological outcomes of all 72 patients were analysed. Patients with minimum follow-up of 5 years were included. Those with less than 5 years of follow-up were reviewed for failures.
Results
Mean age at the time of THA was 56. (range − 18–79). Mean follow-up was 12.9 years (range − 5 to 35.5). All patients had cemented THA. The major late complications included stem loosening in 4, stem fracture - 1, cup loosening - 7, deep infection − 3 and dislocations in 4. Thirteen (18.1%) patients had revisions. Cumulative survival rate is 80.3% (CI: 91.6–69.1) at 10 years.
Conclusion
The outcomes for patients with THA for failed osteosynthesis post NOF fracture is worse in comparison with reported revision rates of THA for acute NOF fracture. The risks of poorer outcomes following salvage THA and morbidity of failed osteosynthesis need to be factored in for NOF fracture management.
