Treatment of displaced femoral neck fractures in adult and elderly patients

Abstract

The aim of this study is to analyze the incidence, comorbidities, treatment results and mortality in patients with displaced femoral neck fractures hospitalized during 01.01.2012 –31.12.2012 in Ortopedy and Traumatology clinic „Vitalie Bețișor”. Materials and methods Study includes 211 cases (136 women with average 73 years and 75 men with average 64 years) treated with displaced femoral neck fracture, that were examined clinically and radiologically after 2 years of follow-up. The results was objectivized with Harris hip score evaluation and EQ-VAS life quality self-assessment. Fracture management was performed depending of patient health state, hospital endowment at that moment and patient/relatives desire. Functional treatment was performed in 64 patients (average 75 years), osteosynthesis in 18 (average 48 years) and hip prosthesis in 129 (average 70.41 years). Results In 2012, medical care received 283 patients (7.51%) with femoral neck fracture, of which displaced was 211 (74.35%), comorbidities was present in 97.15% of these patients. During hospitalization in functionally treated patients group were 3 deaths and those with hip prosthesis – 2. Overall mortality at 2 years was 28.9%. Harris hip score in patients treated functionally is 40.35 points, in those with osteosynthesis – 74.75 points and hip prosthesis – 81.28 points; respectively EQVAS is 21, 61.8 and 79.5. Radiological exam found in osteosynthesis group: pseudoarthrosis in 2 cases and avascular necrosis of femoral head – 3 cases; in hip prosthesis group: subsiding – 4 cases and periarticular ossification – 13 cases. Conclusions Hip fractures in older people is a serious concern for society. In this study femoral neck fractures amounted 7.51% of all hospitalized patients in our clinic. Comorbidities were present at 97.15% of examined cases. Mortality at 2 years follow-up was 28.9%. The best results were found in hip prosthesis group.