Hip fracture in blind patients: Outcomes of hip hemiarthroplasty

Abstract

Background: Blind individuals are more prone to falls and subsequent proximal femoral fractures. While hip hemiarthroplasty is a common treatment option for displaced femoral neck fractures in the elderly, evidence regarding the outcomes of hip hemiarthroplasty in blind individuals is still lacking.Objectives: This retrospective study aimed to evaluate the clinical and radiographic outcomes among a series of blind patients who received hip hemiarthroplasty for femoral neck fractures.Methods: Fifteen patients (15 cases, 11 females) with a mean age of 79.7 years (range, 59-100) at the time of surgery were included in this study. Seven patients were bilaterally blind, while eight patients had unilateral blindness. All of the patients received hip hemiarthroplasty (10 received bipolar and 5 unipolar hemiarthroplasty) for displaced femoral neck or proximal femoral fractures.Results: The mean follow-up for all patients is 49 months. At their last follow-up visits, fourteen cases were able to bear weight fully with or without assistive devices while one patient was wheelchair-bound. The mean calculated pre-injury, and last follow-up postoperative Parker Mobility Index for all patients were 4.7 and 4.5, respectively (p=.8). Three patients (20%) had subsequent, recurrent falls that resulted in other skeletal fractures without hemiarthroplasty dislocations or periprosthetic fractures. One patient developed a prosthetic joint infection and was managed with surgical debridement and antibiotic spacer placement.Conclusions: Hip hemiarthroplasty is a practical treatment option for elderly blind individuals who suffer from displaced femoral neck fractures with overall good implant-related outcomes. Patients should be counseled about the incidence of postoperative recurrent falls and should be instructed to use assistive devices during ambulation.

Keywords

• hip fracture
• blindness
• visual impairment
• hemiarthroplasty
• falls