Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Management of the mobile elderly patient who sustains an intra-capsular neck of femur fracture remains controversial. Current evidence is mixed as to whether total hip arthroplasty (THA), which confers higher surgical and dislocation risk, is significantly superior in function and in reduced rates of reoperation when compared to bipolar hemi-arthroplasty. A group of 110 patients with an intra-capsular NOF fracture who had undergone either THA or Bipolar hemi-arthroplasty and were still alive at the time of follow up were retrospectively identified and matched using the National Hip Fracture Database. Matching criteria included ASA, age, sex, pre-op mobility, pre-op AMTS and source of admission. Follow up was by postal questionnaire. Mean follow up was 24 months in both groups (Range; Bipolar 12-36 months, THA 12-38 months). There was no significant difference in pre-operative Tonnis grade, postoperative Oxford Hip Score (OHS) or Short Form 36 (SF-36) scores between the two groups. 12 dislocations in 5 patients occurred in the THA group and none in the bipolar group. 33/55 Bipolar patients were discharged to their own home compared to 35/55 in the THA group. None of the bipolar hemi-arthroplasties were revised to THA. Higher complication rates were experienced in the THA group with no increase in function.
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PMID:Displaced intracapsular neck of femur fractures in the elderly: bipolar hemiarthroplasty may be the treatment of choice; a case control study. 2623 22

In this study we retrospectively reviewed 251 patients who had internal fixation for neck of femur fracture using cannulated screws. Twenty were lost to follow-up or died soon after surgery. The fracture was displaced in 114 (49.9%) and undisplaced in 117 (50.6%) patients. There were 65 males and 171 females with an average age of 75.7 years. Average follow-up was 12 months. Of the 117 patients with undisplaced fractures 75 (64.1%) healed uneventfully. Further surgery was performed in 21 (17.9%) patients. In the 114 patients with displaced fractures, satisfactory reduction was achieved in 74 patients and of these 54 had good screw placement. Fifty-one (44.7%) patients healed uneventfully. Twenty-two (20%) of the 114 displaced fracture patients required further surgery. Forty (35%) had an unsatisfactory reduction and, of these, 26 (65%) had poor screw placement. Re-operation rates were 17.9% and 20% respectively. The rate of AVN was similar in both fracture types (10.3%-11%), but the rate of non-union was four times higher (2.6%-11.5%) in displaced subcapital fractures. The most important factors within the control of the surgeon that influence the rate of healing are adequate reduction and correct placement of the screws. In this series the reduction was unsatisfactory in 40 (35%) cases of the displaced NOF fractures, and the screws were incorrectly positioned in 46 (40.4%) of the 114 displaced fractures compared with 11 (9.4%) of the 117 undisplaced fractures. This highlights the importance of adequate reduction to enable correct screw placement in displaced fractures. (Hip International 2004; 14: 244-8).
Hip Int
PMID:Success of cannulated screw fixation of subcapital neck of femur fractures. 2824 99