INTRACAPSULAR FEMORAL NECK FRACTURES

COMPARISON OF FUNCTIONAL OUTCOMES IN UNIPOLAR VERSUS BIPOLAR UN-CEMENTED HEMIARTHROPLASTY IN ELDERLY PATIENTS.

Abstract

Objectives: To compare of functional outcomes in terms of post-operative
mobility for unipolar versus bipolar un-cemented hemiarthroplasty in elderly patients with
displaced intracapsular femoral neck fractures. Study Design: Randomized Control Trial.
Setting: Department of Orthopedics Bahawal Victoria Hospital, Bahawalpur. Period: April 2015
to October 2016. Methodology: Sample size is (calculated by taking n6 =138, confidence
interval 95, power of study 80, P1= 33%, P2=13%) 69 in each group. Sampling technique used
was non probability consecutive sampling. All patients who meet the inclusion criteria presenting
to orthopedic unit of Nishtar Hospital Multan with fracture neck of femur were selected for study.
Patients were divided into two groups randomly by lottery method and enrolled for unipolar
or bipolar hemiarthroplasty. Chi-square test was used to compare outcome variable in both
groups. A p-value < 0.05 was considered statistically significant. Effect modifiers like age and
sex was controlled by stratification. Chi square test was applied to see significant difference.
Results: Overall, there were 100% (n=138) patients in this study, both genders. The mean age
of the patients was 66.35±4.29 years. (Range: 60 to 80years)Mean age and SD of group A (no
walking aid) was 54.52 ± 3.10 and in group B (walking aid) 54.99 ± 3.19. Time up go score was
noted as successful 33.3% (n=46) and 66.7% (n=92) as unsuccessful. Walking aid was noted
in 65.2% (n=90) patients. Functional outcome was noted as good in 26.8% (n=37) patients
and noted as bad in 73.2% (n=101) patients. Out of 100% (n=38) patients, good outcome
was 26.3% (n=10) unipolar and 73.7% (n=28) bipolar. Out of 100% (n=100) Bad outcome
was 59% unipolar and bipolar 41%. Conclusion: Functional outcome in term of mobility is
better in case of bipolar prosthesis as compared to unipolar. Thus in our conclusion bipolar
prosthesis is preferred procedure as compared to unipolar hemiarthroplasty in treating patients
with displaced intracapsular femoral neck fracture.