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

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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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Authors and Affiliations

  1. 1st Orthopaedic Department, Evangelismos Hospital, Athens, Greece

    George Mouzopoulos & Mathaios Tzurbakis

  2. Department of General Surgery, Laiko Hospital, University of Medical School of Athens, Athens, Greece

    Michalis Stamatakos & Michalis Safioleas

  3. 2nd Surgical Department, General Hospital Elpis, Athens, Greece

    Helen Arabatzi

  4. 3rd Neurology Department, Papanikolaou Hospital, University of Medical School of Thessaloniki, Thessaloniki, Greece

    George Vasiliadis

  5. Pathology Department, Ahepa Hospital, University of Medical School of Thessaloniki, Thessaloniki, Greece

    George Batanis

  6. Nurse Division of Attikon Hospital, University of Medical School of Athens, Athens, Greece

    Anastasia Tsembeli

  7. Kanari 23, Ag. Antonios Peristeri Attikis, Athens, 12131, Greece

    George Mouzopoulos

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  1. George Mouzopoulos
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  2. Michalis Stamatakos
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  3. Helen Arabatzi
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  4. George Vasiliadis
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  8. Michalis Safioleas
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Correspondence to George Mouzopoulos.

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Mouzopoulos, G., Stamatakos, M., Arabatzi, H. et al. The four-year functional result after a displaced subcapital hip fracture treated with three different surgical options. International Orthopaedics (SICO 32, 367–373 (2008). https://doi.org/10.1007/s00264-007-0321-1

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  • DOI: https://doi.org/10.1007/s00264-007-0321-1

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