Outcomes of Hemiarthroplasty via lateral approach in elderly patients

Abstract

Background: Hip fractures are common and comprise 20% of operative workload of an orthopaedic trauma unit [1]. Hemiarthroplasty for hip fracture is one of the commonest procedures undertaken in Orthopaedics. A number of different surgical approaches may be used for the operation including the anterior, antero-lateral, lateral and posterior approach. Currently the two most commonly used approaches for hemiarthroplasty of the hip are the lateral [7] and the posterior approach [8]. Methods: Patients >60years with displaced neck of femur facture without distal neurovascular deficit presenting and giving written and informed consent were evaluated clinically and radiologically. Total 42 patients underwent surgery with lateral approach. No mortality was observed among the cases. Modified Harris Hip Score (mHHS) was used to compare outcomes. Data was collected in the standard pro forma and patients were followed up at 2, 6 and 12 weeks.Results: Modified Harris Hip Score at 12 weeks was 66.90±9.41 in Lateral approach. The mHHS has increased with successive follow up which was statistically significant. At 12 weeks according mHHS, 4.8% has excellent result, 7.1% had good result, 21.4% had fair result and 66.7% had relatively poor result. The quality of life of the patient has been improving in subsequent follow up and it was statistically significant.Conclusion: Hemiarthroplasty via Lateral approach in elderly patients is safe and effective as operative outcome of the patient significantly increases with time. Post-operative pain, blood loss, prosthesis dislocation and other surgery related complications were minimum and the approach was more suitable for the patient.