Outcome of Primary Total Hip Arthroplasty in Displaced Fracture Neck of Femur in Elderly Patients.

Femoral neck fractures are common fractures and constitute a major health problem especially in elderly. Primary total hip arthroplasty has advantages with little or no comorbidities because it gives good functional outcomes. The study was aimed to assess the outcome of primary total hip arthroplasty in displaced fracture neck of femur in elderly patients. This quasi-experimental study was conducted at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, from March 2021 to September 2023 among 30 patients with displaced fracture neck of femur, aged 60 years or more. All the cases underwent primary total hip arthroplasty by lateral Hardinge approach and were evaluated by clinical features, imaging by X-ray and Harris Hip Score (HHS). Six months follow up was done with clinical and functional assessment. The mean age was 62.5±2.58 years with a male predominance (53.0%). The main cause of injury was fall on ground (77.0%) and most cases there were left side involvement (57.0%). The mean interval between injury and surgery was 18.5±6.85 days. Complications were 2(7.0%) superficial wound infection and 2(7.0%) abductor weakness. In the last follow up after operation, 84.0% cases had no pain and 16.0% cases have complained slight pain. The mean flexion of hip at last follow up was 101.84°±7.25°. Mean abduction and adduction was 30.0°±0.0° and 25.67°±5.04° respectively. Internal rotation and external rotation at last follow up was 20.0°±0.0° and 20.0°±0.0° respectively. The mean HHS at 1st, 2nd and 3rd follow up was 68.64±5.94, 80.47±7.42 and 86.6±5.97 respectively and the increasement was statistically significant at each possible combination (p value <0.001 at each comparison). Finally, out of 30 cases, 16(53.0%) were excellent, 11(37.0%) were good, 2(7.0%) were fair and the rest 1(3.0%) was poor. Based on results of this study, it can be concluded that treatment of displaced femoral neck fracture in elderly patients with primary total hip arthroplasty is a satisfactory method.