Mohammed Alshareef Hatim, Elbarbary Ahmed, Hassan Abdulrahman S, Alzahrani Faris A
Orthopedic Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU.
Medicine and Surgery, University of Jeddah, Jeddah, SAU.
Cureus. 2024 Aug 28;16(8):e68050. doi: 10.7759/cureus.68050. eCollection 2024 Aug.
Displaced femoral neck fractures are prevalent in the elderly, necessitating surgical intervention to restore function and mobility. Hemiarthroplasty, available in both cemented and cementless forms, is a common treatment. While cemented hemiarthroplasty is traditionally preferred, cementless options are gaining attention for their potential advantages, including reduced operative time, decreased blood loss, and preservation of bone stock for future revisions. This case report details the successful application of cementless hemiarthroplasty in a 93-year-old female with a displaced femoral neck fracture, underscoring its feasibility and potential benefits in the very elderly. The patient, with multiple comorbidities including hypertension, cerebrovascular accident, osteoarthritis, dementia, chronic kidney disease, diabetes mellitus, osteoporosis, and limited mobility, presented with left hip pain following a fall. Radiographs confirmed a displaced femoral neck fracture. Cementless hemiarthroplasty was performed using the lateral Harding approach, achieving stable fixation without cement. Postoperative care involves standard pain management, early mobilization, and monitoring for complications. This case highlights the potential benefits of cementless hemiarthroplasty, such as reduced operative time and decreased risk of cement-related complications, particularly in elderly patients with good bone quality. The successful outcome, characterized by stable fixation and absence of intraoperative or early postoperative complications, emphasizes the importance of individualized patient assessment and tailored surgical approaches. Further research is needed to refine guidelines and expand the evidence base for the use of cementless techniques in this demographic.
移位型股骨颈骨折在老年人中很常见，需要手术干预以恢复功能和活动能力。半髋关节置换术有骨水泥型和非骨水泥型两种，是一种常见的治疗方法。虽然传统上更倾向于骨水泥型半髋关节置换术，但非骨水泥型因其潜在优势，包括手术时间缩短、失血减少以及为未来翻修保留骨量，而受到关注。本病例报告详细介绍了非骨水泥型半髋关节置换术在一名93岁移位型股骨颈骨折女性患者中的成功应用，强调了其在高龄患者中的可行性和潜在益处。该患者患有多种合并症，包括高血压、脑血管意外、骨关节炎、痴呆、慢性肾病、糖尿病、骨质疏松症且活动受限，跌倒后出现左髋疼痛。X线片证实为移位型股骨颈骨折。采用外侧哈丁入路进行非骨水泥型半髋关节置换术，未使用骨水泥实现了稳定固定。术后护理包括标准的疼痛管理、早期活动以及并发症监测。本病例突出了非骨水泥型半髋关节置换术的潜在益处，如手术时间缩短和骨水泥相关并发症风险降低，特别是在骨质良好的老年患者中。以稳定固定且无术中或术后早期并发症为特征的成功结果，强调了个体化患者评估和量身定制手术方法的重要性。需要进一步研究以完善指南并扩大在这一人群中使用非骨水泥技术的证据基础。
