STUDY OF FUNCTIONAL OUTCOME OF TOTAL HIP REPLACEMENT VERSUS HEMIARTHROPLASTY IN FRACTURE NECK OF FEMUR

Introduction:Inelderlywithdisplacedfemoral neck fractures(FNFs),choicebetweenhemiarthroplastyandTHRhasalwaysbeenadifficultone,boththetreatmentmodalitieshavingtheirownproponents.Hemiarthroplastyisalesscomplexsurgeryandhasbeenassociatedwithreducedcomplications andlowerinitialcosts while THRontheotherhandhasbeenassociatedwithbetterpostoperativefunction. MaterialandMethods:Thisstudy wasconductedonpatientswithdisplacedFNFswithagemorethan65years,operatedeitherwithTHRorhemiarthroplastyon40patients(20ineachgroup).SouthernMooreapproachwasusedforexposureofthehipjoint.Thefollowupwasdoneat1,3and6monthsduringwhichfunctionalassessmentwasdoneusingHarrisHipScore(HHP)andassociatedcomplicationswerealsoanalyzed. Results:ThemeanHHPwashigherinTHRgroupthroughoutthestudyperiodbutitwasnotstatisticallysignificant.ThecomplicationsinhemiarthroplastyGroupwereInfectionin10%,PulmonaryEmbolismin5%ofpatients.ThecomplicationsinTHRGroupwereInfectionin5%,LLDin15%,Dislocationin5%ofpatients. Conclusion:THRprovestobesuperiorintermsofhigherincreaseinHHP.DislocationratesandLimblengthdiscrepancieswerehigherintheTHRgroupbutcanbepreventedwithadequatemeasureswhilethe other complicationswerecomparableinboththegroups.THRshouldbepreferredmethodofmanagementofdisplacedFNFsinactiveelderlypatientswithacceptableratesofcomplications.