Summary
One hundred and fifty four patients with a displaced subcapital fracture of the neck of the femur were treated by primary replacement with a cemented Thompson prosthesis. The average age of the patients was 74.8 years and most had evidence of generalised disease. Two patients had the procedure performed on both sides. The operation was carried out through an antero-lateral approach. Mobilisation began on the day following operation and patients were encouraged to walk on the fifth day. No dislocations were seen. The important early complications were not at the site of operation but were secondary to associated diseases. Following early unrestricted weight bearing 111 patients (71.1%) were discharged within three weeks of the operation. Twenty three (14.7%) died during the six weeks following the procedure. At follow up between one and seven years after operation (mean 3.9 years), fifty patients had died, but of the 63 survivors contacted 78% had a good to excellent result whilst only 5% were classified as poor.
Résumé
154 malades présentant une fracture souscapitale du col du fémur avec déplacement ont été traités d'emblée par mise en place d'une prothèse de Thompson cimentée. L'âge moyen des patients était de 74,8 ans et la plupart d'entre eux présentaient les signes d'une maladie associée. Deux sujets ont été opérés des 2 hanches. L'opération a été réalisés par voie antéro-externe, la mobilisation entreprise dès le lendemain et les malades ont commencé à marcher au 5e jour. Il n'y a pas eu de luxation. Les complications précoces les plus graves n'ont pas porté sur le foyer opératoire, mais ont été le fait d'affections associées. Grâce à la reprise précoce de l'appui, 111 malades (71,1%) ont pu quitter l'hôpital trois semaines après l'opération. 23 (14,7%) sont morts durant les six premières semaines.
Avec un recul de 1 à 7 ans après l'intervention (en moyenne 3,9 ans) 50 opérés étaient morts, mais sur les 63 survivants revus 78% avaient un bon ou un excellent résultat tandis qu'il pouvait être considéré comme mauvais dans 5% des cas seulement.
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Read in part at the XIV World Congress of SICOT (Tokyo 1978)
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Tonino, A.J. The Thompson prosthesis in the treatment of subcapital fractures of the neck of the femur. International Orthopaedics 6, 225–231 (1983). https://doi.org/10.1007/BF00267143
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DOI: https://doi.org/10.1007/BF00267143