Vol. 3, Issue 3, Part B (2019)

Background and Objective: Fractures of the femoral neck, which can occur as a consequence of low-energy trauma like falls, are a prevalent and severe orthopaedic problem among the elderly. Comorbidities and decreased bone quality make therapy difficult for these injuries, which in turn cause functional deterioration, severe morbidity, and mortality. The main method of treatment to restore mobility and minimize consequences is surgical surgery. By comparing various surgical techniques and measuring postoperative recovery and complications, this study sought to examine the functional and clinical results of surgical treatment for femoral neck fractures in older individuals.

Material and Methods: A prospective observational study was performed on 50 senior patients (aged ≥ 65 years) diagnosed with femoral neck fractures. This research was performed in the Department of General Surgery, Madha Medical College and Research Institute, located at Kovur, Mangadu, Thandalam, Chennai, Tamil Nadu, India, from April 2018 to March 2019.  Patients received treatment through one of the following techniques, according by fracture type, bone quality, and surgeon preference: internal fixation (cannulated screws), hemiarthroplasty, or Total Hip Arthroplasty (THA). Preoperative data, comorbidities, surgery duration, intraoperative hemorrhage, hospital length of stay, and postoperative problems were documented.

Results: The following procedures were performed on the 50 patients: hemiarthroplasty on 28, internal fixation on 12, and total hip arthroplasty on 10. The majority (62%), who were female, had an average age of 74.2±6.5 years. The average time required for the surgery was 48±10 minutes for internal fixation and 90±12 minutes for THA. Infectious problems, dislocations, and delayed wound healing were reported in 18% of patients following surgery. Patients who underwent arthroplasty, whether partial or total, had noticeably superior functional results at the 12-month follow-up (mean HHS: 81.5±6.2) in contrast to those who underwent internal fixation (mean HHS: 68.4±8.1). Among patients with numerous comorbidities, the mortality rate at 1 year was 6%.

Conclusion: When it comes to femoral neck fractures in older individuals, surgical therapy offers good functional results. Arthroplasty, especially hemiarthroplasty and total hip arthroplasty, has a better track record of recovery and fewer problems than internal fixation. To enhance postoperative results and quality of life in this group, early surgical intervention and the selection of the surgical technique according to patient-specific criteria are crucial.