Outcome of treatment of fracture neck of femur using hemiarthroplasty versus dynamic hip screw.

BACKGROUND

Fracture neck of femur is a frequent and severe injury with consequent high morbidity and mortality. Surgical treatment has been established as the gold standard; however, the surgical option remains a dilemma. Hemiarthroplasty with and Dynamic hip screw are established treatment modalities for femoral neck fractures.

OBJECTIVE

To give a comparative analysis of the two treatment modalities with respect to duration of surgery, blood transfusion, hospital stay, wound complications, number of revision surgeries, mortality rate and functional outcome.

MATERIALS AND METHODS

Retrospective data was obtained over a 5 year period. All patients with femoral neck fractures treated with either hemiarthroplasty or Dynamic Hip screw were consecutively selected. Data was analysed using SPSS version 21.

RESULTS

A total of 86 patients were studied with forty three patients each in the hemiarthroplasty and DHS study groups. The Mean duration of surgery was 107±28 and 109±29 minutes, mean estimated blood loss was 320±98mls and 341±122mls, rate of blood transfusion was 54% and 58%, and mean post-op hip score was 15±1 (Good) and17±1 (Very Good) for Hemiarthroplasty and DHS groups respectively.

CONCLUSION

The two study groups were comparable with respect to duration of surgery, duration of hospital stay and early mobilization with external support. Hemiarthroplasty study group was superior with respect to estimated blood loss, requirements for blood transfusion, complications of mechanical failures and need for revision surgeries while the DHS study group had superior hip functional outcome. This result suggests that the DHS may allow better restoration of function and should be favoured for treatment of fracture neck of femur in well selected patients that meet the indications for surgery whenever the technical competence and facilities exist.