FEMORAL NECK FRACTURE TREATED BY HEMIARTHROPLASTY, A COMPARATIVE STUDY BETWEEN WATSON-JONES AND MOORE APPROACHES
Basrah Journal of Surgery,
Volume 21, Issue 1, Pages 43-48
AbstractAli A Alwan Al-Tamimi*, Qahtan Maaroof Rahman# &Warzer Fatah Shali@
*MB,ChB, FICMS (Orth.), Lecturer, College of Medicine; University of Sulaimaniyah. # MB,ChB, Diploma (Orth.), Orthopaedics surgeon, Azadi teaching hospital; Kirkuk, Iraq. @MB,ChB, Diploma (Orth.), FRCS (London), Head of Orthopaedic Department, Sulaimaniyah Teaching Hospital, IRAQ.
The treatment options for fractures of the femoral neck whether displaced or nondisplaced, are osteosynthesis, hemiarthroplasty, and total joint arthroplasty. Numerous reports have favored osteosynthesis over hemiarthroplasty. However, the high rates of non-union and a vascular necrosis associated with osteosynthesis, has led others to advocate femoral head replacement over internal fixation.
This is a prospective study carried on 96 patients (36 male and 60 female) having intracapsular femoral neck fractures who were admitted to the department of the orthopaedic surgery in Sulaimaniyah Teaching Hospital between September 2008 and September 2013.
The patient's ages ranged from 62-88 years (average 71 years). All patients were treated by hip hemiarthroplasty (partial hip replacement) with two types of approaches. Watson Jones (antero-lateral) approach was used in 40 cases (41.7%) and Moore (posterior) approach in 56 cases (58.3%). The aim of this study is to compare the outcome between these two approaches peroperatively and postoperatively to determine which approach is better for hip hemiarthroplasty.
The outcome of these two approaches were studied and analyzed monthly and the results of both approaches compared with each other and compared also with other studies.The duration of follow-up ranged between 12-48 months with average of 34 months.
In conclusion, rate of dislocation, infection, deep vein thrombosis and sciatic nerve injury were more in Moore approach, while liability to fracture femur during operation and time of surgery were more in Watson-Jones approach.
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