MANAGEMENT OF NEGLECTED FRACTURE NECK OF FEMUR WITH CEMENTED BIPOLAR HEMIARTHROPLASTY: A PROSPECTIVE OBSERVATIONAL STUDY.

Background: In geriatric population femoral neck fractures is one of the most common injuries. Very little literature is available as far as treatment of neglected femoral neck fractures. Material and methods: In this prospective observational study, 20 cases of neglected (3 to 8 months, mean 5.2 months) intracapsular fracture neck of femur in elderly patients with mean age of 72.8 years (range: 66-87 years) were treated by a single operating surgeon with cemented bipolar hemiarthroplasty. This study was conducted at the post graduate Dept. Of Orthopaedics, G.M.C. Jammu from November 2017 to October 2018. The results and follow-up were evaluated; functional results were analyzed by using modified Harris hip scoring system. Results: Four patients had a Garden type III fracture radiologically, while 16 had a Garden type IV. In 75% of cases, the mode of injury was trivial trauma. We lost one patient to follow-up after 12 months; while two others died due to medical conditions (10?16 months post surgery). Seventeen patients were followed to final follow-up (average 14 months; range: 12?25 months. Some of the complications observed were one patient had superficial infection of the wound and two patients had limb length discrepancy (~1.9cm), following the procedure. There were 50% excellent results and 30% good results. Conclusions: No patient was put on pre operative skeletal or skin traction. Cemented Bipolar hemiarthroplasty was found to be safe and gave satisfactory results in 80%.