Abstract：Objective To detect the initial results of total hip arthroplasty (THA) after failure of internal fixation of femoral neck fractures and investigate the key points in surgical procedures and prosthesis selection.Methods A retrospective analysis was performed on 36 cases who had THA for femoral neck fractures due to the initially failed internal fixation between January 2007 and December 2012.There were 21 males and 15 females,with age ranging from 46 to 72 years (mean,58.6 years).After internal fixation,13 cases were complicated by femoral head necrosis,eight fracture nonunion,and 15 fracture nonunion combined with femoral head necrosis.All the 36 cases had cementless THA,including proximally fixed stem in 25 cases and distally fixed stem in 11 cases.Harris hip score was assessed before operation and at follow-up.Results All the cases received a follow-up of 26-52 months (mean,32.5 months).Mean Harris hip score improved from 26.3 to 83.6,including excellent results in 12 cases,good in 22,and fair in two,with excellence-good rate of 94％.Conclusion With respect to the failed internal fixation of femoral neck fractures,THA is an effective remedial method to improve hip function and quality of life of the patients.
ZHANG Hao,LAN Yu-ping,XU Bing.. arly outcome of total hip arthroplasty for failed internal fixation of femoral neck fractures[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(12): 1155-1158.
［1］Zielinski SM, Meeuwis MA, Heetveld MJ, et al. Adherence to a femoral neck fracture treatment guideline. Int Orthop, 2013, 37(7):1327-1334.
［2］Dai Z, Li Y, Jiang D. Meta-analysis comparing arthroplasty with internal fixation for displaced femoral neck fracture in the elderly. J Surg Res, 2011, 165(1):68-74.
［3］Fisher MA, Matthei JD, Obirieze A, et al. Open reduction internal fixation versus hemiarthroplasty versus total hip arthroplasty in the elderly: a review of the National Surgical Quality Improvement Program database. J Surg Res, 2013, 181(2):193-198.
［4］Bilsel K, Erdil M, Gulabi D, et al. Factors affecting mortality after hip fracture surgery: a retrospective analysis of 578 patients. Eur J Orthop Surg Traumatol, 2012, 16. ［Epub ahead of print］.
［5］Karaeminogullari O, Demirors H, Atabek M, et al. Avascular necrosis and nonunion after osteosynthesis of femoral neck fractures: effect of fracture displacement and time to surgery. Adv Ther, 2004, 21(5):335-342.
［7］Lee YK, Ha YC, Park C, et al. Trends of surgical treatment in femoral neck fracture. a nationwide study based on claim registry. J Arthroplasty, 2013, 28(10):1839-1841.
［8］Chammout GK, Mukka SS, Carlsson T, et al. Total hip replacement versus open reduction and internal fixation of displaced femoral neck fractures: a randomized long-term follow-up study. J Bone Joint Surg (Am), 2012, 94(21):1921-1928.
［10］Leonardsson O, Sernbo I, Carlsson A, et al. Long-term follow-up of replacement compared with internal fixation for displaced femoral neck fractures: results at ten years in a randomised study of 450 patients. J Bone Joint Surg (Br), 2010, 92(3):406-412.
［12］Jain NB, Losina E, Ward DM, et al. Trends in surgical management of femoral neck fractures in the United States. Clin Orthop Relat Res, 2008, 466(12):3116-3122.
［13］Gandhi R, Salehi M, Davey JR. Cemented bipolar hemiarthroplasty in osteoporosis for failed femoral neck fixation. Can J Surg, 2009, 52(3):E44-E46.
