Femoral neck fractures have been considered ‘unsolvable fracture’ in the olden era of orthopaedics due to high rate of associated complications, which include nonunion and avascular necrosis of the femoral head.
Prosthetic replacement as a primary procedure eliminates osteonecrosis and non union as complications of femoral fractures and also allows immediate weight bearing to return elderly patients to activity and help avoid complications of recumbency and inactivity. 2
The decision to perform hemi arthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. So, in view of varied opinions we desire to compare the efficiency of these two prosthesis unipolar and bipolar prosthesis for the management of intra capsular fracture neck femur in elderly.
Methods: 112 patients above 60 years and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either AMP or bipolar HA, in the department of Orthopaedics, AIMS BG Nagara between May 2013 to May 2016.The patients were followed up at 6weeks, 12 weeks, 6 months and 1year. Functional outcome was assessed and compared with Harris hip score and radiological parameters
Results: The two groups of patients with mean age of 70.4 in AMP group and 69.1 in Biploar group did not differ in their pre-injury characteristics (sex, fracture pattern, comorbidity, mode of injury and pre-injury ambulatory status) and perioperative parameters such as duration of operation, blood loss, hospital stay and mortality. The mean Harris hip score in Bipolar and AMP group was 90.03 and 84.4, respectively. Functional activities like use of public transport was better with bipolar group. Incidence of complications like Superficial infection, haematoma and acetabular erosion was encountered in AMP group.
Conclusion: The use of a bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur. Moreover the cost difference between AMP and Bipolar prosthesis is not much in our country.