A Comparison of Bipolar Hemiarthroplasty versus Dynamic Hip Screw Fixation of Basicervical Femoral Neck Fractures

Abstract

Background: Surgical treatment of basicervical femoral neck fractures, which is biomechanically similar to intertrochanteric fractures, is an internal fixation by DHS and anti-rotation screw. Since devise failure is one of the most noticeable complications of these surgical procedures, this study aimed to compare the bipolar Hemi-arthroplasty with DHS plate internal fixation in elderly patients with a basicervical femoral neck fracture. Methods: This is a randomized controlled clinical trial in which 60 patients with femoral neck fractures were divided into two groups of 30 control (DHS fixation) and intervention (Bipolar hemiarthroplasty) randomly. Functional evaluation was completed by the HHS questionnaire and VAS scale for pain assessment, postoperative complications at 6 months and one year postoperatively. Data were analyzed using Stata software. Findings: The overall mean age in the control group was 73.95± 9.85 and in the intervention group 74.22±7.85 years. Three patients in the intervention group and 6 patients in the control group were excluded. HHS in Sixth months and one year after surgery were significantly higher in the bipolar group compared to the DHS group(p-value<0.0003and p-value < 0.0097). there were no significant differences in VAS between the two groups (p-value<0.4557 and p-value < 0.4578).The rate of device failure in the control group was 2 cases. Conclusion: Overall, the results of this study show that bipolar hemiarthroplasty surgery is more effective than internal fixation by DHS plate in improving the patients' quality of life based on the HHS scores, and the lower failure rate as well as diminishing of the reoperation rate.

Keywords

• Femoral Neck Fractures; Hemiarthroplasty; Fracture Fixation