Mishra A K, Chalise P K, Shah S B, Adhikari V, Singh R P
Department of Orthopaedics, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.
Nepal Med Coll J. 2013 Mar;15(1):81-3.
Fracture neck of femur is most commonly encountered fractures in elderly population. Hemiarthroplasty is generally considered to be the treatment of choice in most active elderly patients. However, there is inadequate evidence to support the choice between unipolar or bipolar prosthesis. This study was conducted to analyze the outcome regarding pain, hip function, complication and acetabular erosion in patients randomly selected and treated with Austin Moore's or Bipolar hemiarthroplasty in our setup. The study included total of 40 patients (17 males and 23 females) with intracapsular neck of femur fractures with mean age of 67 years (55-85 years). 20 patients each were treated with Hemiarthroplasty using Austin Moore's and Bipolar prosthesis. The patients were followed up at intervals of 2 weeks, 6 weeks, 24 weeks and 1 year after the operation and evaluated clinically and radiologically. There were no significant differences between the groups regarding complication. The Harris hip score were 81.95% (SD - 2.99) in Austin Moore's hemiarthroplasty and 79.15% (SD - 2.94) in Bipolar hemiarthroplasty (p = 0.812), whereas acetabular erosion was 20.05% in Austin Moore's hemiarthroplasty and 5% in Bipolar hemiarthroplasty (p = 0.758) with no mortality seen during lyear follow up. The intracapsular neck of femur fracture in active elderly patients treated with Austin Moore's hemiarthroplasty had better outcome regarding pain and hip function whereas high acetabular erosion compared to patients treated with Bipolar hemiarthroplasty though the difference is statistically insignificant.
股骨颈骨折是老年人群中最常见的骨折。半髋关节置换术通常被认为是大多数活动能力较好的老年患者的首选治疗方法。然而，目前尚无充分证据支持单极或双极假体之间的选择。本研究旨在分析在我们的研究中随机选择并接受奥斯汀·摩尔假体或双极半髋关节置换术治疗的患者在疼痛、髋关节功能、并发症和髋臼侵蚀方面的结果。该研究共纳入40例患者（17例男性和23例女性），均为股骨颈囊内骨折，平均年龄67岁（55 - 85岁）。分别有20例患者接受了奥斯汀·摩尔假体和双极假体的半髋关节置换术。术后每隔2周、六周、24周和1年对患者进行随访，并进行临床和影像学评估。两组在并发症方面无显著差异。奥斯汀·摩尔半髋关节置换术的Harris髋关节评分是81.95%（标准差 - 2.99），双极半髋关节置换术的Harris髋关节评分为79.15%（标准差 - 2.94）（p = 0.812），而奥斯汀·摩尔半髋关节置换术的髋臼侵蚀率为20.05%，双极半髋关节置换术为5%（p = 0.758），在1年的随访期间未观察到死亡病例。接受奥斯汀·摩尔半髋关节置换术治疗的活动能力较好的老年患者的股骨颈囊内骨折在疼痛和髋关节功能方面有更好的结果，尽管差异无统计学意义，但其髋臼侵蚀率高于接受双极半髋关节置换术治疗的患者。
