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