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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Background Total hip replacement is an established treatment for failed fixation of femoral neck fractures (FF.FNFs) as well as acute FNFs. Objectives To analyze and compare the results of primary total hip arthroplasty versus cases of FF.FNFs. Patients and methods In the period between June 2016 and June 2021, this prospective case series included 40 patients classified into two groups: group A included 20 patients with displaced FNFs, Group B included 20 patients with FF.FNFs. Preoperative, operative, and postoperative clinical and radiological data are collected and evaluated by Harris hip score. Results FNF had older average age of 62 years, while 49 years in FF.FNF. In total, 11 males, while seven males in FF.FNF more ambulant preoperatively, shorter operative time, and nine cementless prosthesis, while 11 cementless in FF.FNF, less hospital stay, and earlier postoperative ambulation. In FNF, early complications were two superficial infections, while in FF.FNF were one superficial and one deep infection. In FNF, late complications were two cases of thigh pain. In FF.FNF were three cases of thigh pain and one case of dislocation. Total Harris hip score result in FNF was 84.85, while 83.15 in FF.FNF. The average interval between initial surgery and total hip surgery was 15 months. Cannulated screws were the commonest hardware used for initial fixation of FNFs (85%); nonunion (55%) and avascular necrosis (45%) are the commonest causes of FF.FNFs. Conclusion Total hip replacement is a good salvage treatment for cases of FF.FNFs, although not giving full function comparable to total hip replacement in FNFs.

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