Diaphyseal-locking Bipolar Hemiarthroplasty for Displaced Femoral Neck Fracture

以骨幹固定式雙極人工半髖關節治療移位股骨頸骨折

蔡傳恩(Chuan-En Tsai) ； 陳威明(Wei-Ming Chen) ； 吳博貴(Po-Kuei Wu) ； 陳正豐(Cheng-Fong Chen) ； 江昭慶(Chao-Ching Chiang) ； 黃清貴(Ching-Kuei Huang) ； 劉建麟(Chien-Lin Liu) ； 陳天雄(Tain-Hsiung Chen)

《Journal of Orthopaedic Surgery Taiwan》 26卷4期 (2009/12) Pp. 180-187

並列摘要

Purpose: To review the short term results of the anatomical medullary locking (AML, 5/8 porous-coated, 6-inch stem) bipolar hemiarthroplasty in treating displaced femoral neck fractures (FNFs) with immediately full weight bearing.
Methods: We retrospectively reviewed the charts of 58 consecutive patients with displaced FNF s seen between 2002 and 2008 at our institution. All received AML bipolar hemiarthroplasty (DePuy, Warsaw, IN). The mean age was 71.6 years (range, 60 to 80). A modified anterior-lateral approach was used for all surgeries. Full weight bearing was allowed from the third postoperative day except in two patients who suffered from intraoperative fracture. The mean follow-up period was 39 months (range, 6 to 80). Biplanar hip radiographs were taken to evaluate femoral geometry (based on Dorr classification); post-operative dislocation, subsidence and fracture were also evaluated.
Results: In 58 AML stems, no subsidence was seen and no revision surgery was indicated. Of three fractures (5.2%), two were intraoperative and one was postoperative; none led to subsidence or major functional impairment. Stem survival rate to date is 100% (58/58).
Conclusions: AML bipolar hemiarthroplasty, regardless of femur geometry, successful treats displaced FNF. Immediate weight bearing as early as three days postoperatively is permitted when there is no intraoperative fracture. This stem provides satisfactory initial stability and a low incidence of subsidence in patients who cannot follow a protective partial weight bearing protocol.

並列關鍵字

femoral neck fracture ； porous-coated ； weight bearing ； subsidence