PROMOTING ACCESS TO AFRICAN RESEARCH

Nigerian Journal of Orthopaedics and Trauma

Log in or Register to get access to full text downloads.

Remember me or Register



DOWNLOAD FULL TEXT Open Access  DOWNLOAD FULL TEXT Subscription or Fee Access

Femoral neck fractures: A prospective assessment of the pattern, care and outcome in an orthopaedic centre

I Onche Icha, W Yinusa

Abstract


OBJECTIVE: To review the pattern of femoral neck fractures, complications and outcome following fixation with Austin-Moore endoprosthesis.


METHOD: A two year prospective study in patients who had fracture of the femoral neck based on strict inclusion criteria. All the patients were treated by Austin-Moore hemiathroplasty via the classical southern approach. Complications were ocumented as they developed and probable causative factor evaluated. Minimum follow up was 32 completed weeks.


OUTCOME MEASURES: Interval between surgery and mobilization, return to full activity and modification of lifestyle after surgery.


RESULTS: Thirty patients were recruited, 21 males and 9 females with a mean age of 67.4 years. Twenty (66.7%) sustained injuries in a road traffic accident. Garden's grade 3 and 4 were the most common types. The presence of co-morbid factors and initial management by traditional bonesetters caused delay in instituting definitive surgery. Infective complication was the most common complication; mainly post operative wound infection (20.0%) urinary tract infection (23.3%) and upper respiratory tract infection(30.3%).Existing co-morbid factors, prolonged pre-operative stay, duration of operation and invasive ancillary procedures were responsible for these. Twenty (66.7%) patients had returned to full mobilization at 12 weeks of follow-up.


CONCLUSION: Austin-Moore hemiathroplasty is the preferred choice of fixation in elderly Nigerians especially if displaced. Correction of co-morbidfacors pre-operatively, antithrombotic prophylaxis, perioperative antibiotics and early mobilization should form the cornerstone of treatment if good outcome is to be expected.

KEY WORDS: Femoral neck, Austin-Moore endoprosthesis, co –morbid factor.

Nigerian Journal of Orthopaedics and Trauma Vol.3(1) 2004: 42-49



http://dx.doi.org/10.4314/njotra.v3i1.29226
AJOL African Journals Online