Outcomes of salvage total hip arthroplasty after failed cannulated screw fixation of fractured neck of femur.

Autor: Turnbull JA; Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Preston, PR2 9HT, UK., Vicary-Watts R; Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Preston, PR2 9HT, UK., McLauchlan GJ; Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Preston, PR2 9HT, UK.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2024 Jul 25; Vol. 59, pp. 119-122. Date of Electronic Publication: 2024 Jul 25 (Print Publication: 2025).
DOI: 10.1016/j.jor.2024.07.009
Abstrakt: Introduction: In a UK setting, cannulated hip screws (CHS) are frequently used to fix femoral neck fractures. Although often a relatively quick procedure and one that is delegated to more junior surgeons, failure rates of up to 23 % have been reported. The salvage procedure is total hip arthroplasty (THA). In this paper we report the outcomes of a series of THA for failed cannulated screw fixation.
Methods: Retrospective analysis of one of the largest reported single cohort of 600 CHS procedures spanning 14 years from 2007 to 2020 from a single centre was performed. This identified 55 patients who went on to have total hip arthroplasty, 36 women, 19 men, mean (SD) age: 71.5 (13.6) years. Patient characteristics, reason for fixation failure and complications were recorded. Oxford hip scores were available for 47 patients. Comparison was made with a series of patients who underwent primary THA for fracture.
Results: Failure rate of CHS was 9.2 % in our cohort. Mean (SD) time from fixation to arthroplasty was 15.5 (12.4) months. Two patients (3.6 %) patients had a postop complication, one requiring further surgery. Mean (SD) preoperative Oxford hip score was 11.4 (8.0). This improved to 38.8 (10.4) at 1 year and 32.1 (14.9) at 5 years postoperatively. This compares to a mean (SD) of 39.7 (8.6) at 1 year and 39.4 (8.1) at 5 years in a group of 185 patients undergoing primary THA for hip fracture. Displaced fractures that went on to failure had better postop scores than nondisplaced fractures.
Discussion: The failure rate of CHS is relatively low and the salvage procedure of THA has a minimal complication rate and outcomes as good as primary THA for hip fracture.
(© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze: MEDLINE
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