International Orthopaedics

, Volume 32, Issue 3, pp 367–373 | Cite as

The four-year functional result after a displaced subcapital hip fracture treated with three different surgical options

  • George Mouzopoulos
  • Michalis Stamatakos
  • Helen Arabatzi
  • George Vasiliadis
  • George Batanis
  • Anastasia Tsembeli
  • Mathaios Tzurbakis
  • Michalis Safioleas
Original Paper

Abstract

According to the literature, hip function after hip fracture is affected by the type of surgery. Our aim was to determine the correlation between surgical treatment of hip fracture and postoperative function in the elderly. Inclusion criteria were displaced hip fracture and age over 70 years. One hundred and twenty-nine participants were randomly divided into three groups according to the type of the surgical operation they underwent (hemi-arthroplasty [Merete, Berlin, Germany], total arthroplasty [Plus; De Puy, Warsaw, IN, USA] and internal fixation [Richards plate screw; Smith & Nephew, Memphis, TN, USA]). The function of the patients was estimated using the following parameters: the Barthel Index and Harris Hip Score, the range of passive hip motion, the gait speed of individuals, after 1 and 4 years of follow-up. The Barthel Index scores after 4 years of follow-up were 85.3, 82.6, 80.1 after total arthroplasty, hemi-arthroplasty and internal fixation respectively. Similarly, the Harris Hip Scores after 4 years of follow-up were 83.7, 79.5 and 73.6. The range of passive hip motion in the three groups of patients did not differ significantly (p > 0.05). Also, patients of the total arthroplasty and hemi-arthroplasty groups walked faster than the patients of the internal fixation group 4 years after discharge (p < 0.05). In conclusion, we believe that total hip arthroplasty is the treatment of choice for displaced subcapital hip fractures in patients over 70 years old.

Résumé

Selon la littérature, la fonction de la hanche après traitement d’une fracture dépend du type d’intervention. Le but de notre étude est d’apprécier la corrélation qui existe entre le traitement chirurgical et la fonction post-opératoire chez les patients âgés. Les critères d’inclusion ont été la notion d’une fracture déplacée chez les patients âgés de plus de 70 ans. Cent vingt-neuf patients ont été randomisés en trois groupes selon le type d’intervention, prothèse intermédiaire de type Merete, prothèse totale de type Plus et fixation interne par vis plaque de type Richards. La fonction des patients a été estimée selon les paramètres suivants : index de Barthel, Score de Harris, mobilité passive de la hanche et vitesse de marche après un à quatre ans de suivi. Le score de Barthel à quatre ans, post opératoire est passé respectivement à 85,3, 82,6, 80,1 après prothèse totale, prothèse intermédiaire et fixation interne, de même en ce qui concerne le score de Harris qui est passé respectivement de 83,7, 79,5, 73,6. La mobilité passive de la hanche dans les trois groupes ne montre pas de différence significative. Les patients ayant bénéficié d’une prothèse totale ou d’une prothèse intermédiaire ont une marche plus rapide que les patients ayant bénéficié d’une fixation interne (p < 0.05). En conclusion, nous pensons que la prothèse totale de hanche est le traitement de choix pour les fractures déplacées sous capitale de la hanche chez les patients de plus de 70 ans.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • George Mouzopoulos
    • 1
    • 7
  • Michalis Stamatakos
    • 2
  • Helen Arabatzi
    • 3
  • George Vasiliadis
    • 4
  • George Batanis
    • 5
  • Anastasia Tsembeli
    • 6
  • Mathaios Tzurbakis
    • 1
  • Michalis Safioleas
    • 2
  1. 1.1st Orthopaedic DepartmentEvangelismos HospitalAthensGreece
  2. 2.Department of General Surgery, Laiko HospitalUniversity of Medical School of AthensAthensGreece
  3. 3.2nd Surgical DepartmentGeneral Hospital ElpisAthensGreece
  4. 4.3rd Neurology Department, Papanikolaou HospitalUniversity of Medical School of ThessalonikiThessalonikiGreece
  5. 5.Pathology Department, Ahepa HospitalUniversity of Medical School of ThessalonikiThessalonikiGreece
  6. 6.Nurse Division of Attikon HospitalUniversity of Medical School of AthensAthensGreece
  7. 7.AthensGreece

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