Summary
The management of displaced intracapsular fractures of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age.
Of 49 patients who were interviewed an average of 4.6 years after total hip replacement, 81.6% had excellent or good results as assessed by the Harris Hip Score. At that time two hips had been revised and another converted to Girdlestone due to deep infection. The survival of the prostheses was at 5 years 91.3%.
It is concluded that total hip replacement is an established method of management for a selected group of patients with this injury, but further prospective studies are needed in order to define the groups of patients that benefit the most.
Résumé
Le traitement des fractures de la hanche intracapsulaires déplacées est toujours controversé à cause de la haute incidence de complications après fixation interne ou hémiarthroplastie. Afin d'éviter certaines de ces complications, nous avons réalisé le remplacement primaire total de la hanche pour les patients mobiles et autonomes de plus de 65 ans.
Sur 49 patients interrogés 4,6 ans en moyenne après une prothèse totale de hanche, 81,6% avaient d'excellents ou de bons résultats selon le score Harris pour la hanche. A cette époque a hanches avaient été revues et une autre avait été convertie en Girdlestone à cause d'une infection. La survie à 5 ans des prothésés était de 91,3%.
En conclusion,la prothèse totale de hanche est un moyen bien établi de traiter un groupe sélectionné de patients ayant cette atteinte, mais il faut d'autres études prospectives afin de définirles groupes de patients qui en bénéficieront le plus.
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Nikiforidis, P., Babis, G.C., Papaioannou, N. et al. The role of primary total hip replacement for the treatment of the displaced femoral neck fractures. Eur J Orthop Surg Traumatol 7, 23–26 (1997). https://doi.org/10.1007/BF00578828
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DOI: https://doi.org/10.1007/BF00578828