Bipolar hemiarthroplasty for intracapsular femoral neck fractures in elderly patients.

PURPOSE: To report outcome of 30 patients who underwent bipolar hemiarthroplasty for intracapsular femoral neck fractures. METHODS: 18 women and 12 men aged 56 to 86 (mean, 70) years with Garden type III (n=7) or IV (n=23) intracapsular femoral neck fractures underwent cemented (n=5) or uncemented (n=25) bipolar hemiarthroplasty. Pain was evaluated using the visual analogue score. Mobility status was classified as ambulation with or without aid (a cane or walker). Stability of the prosthesis was classified as stable or unstable. Functional outcome was evaluated using the Harris Hip Score. RESULTS: The mean length of hospital stay was 15.3 (range, 4-29) days. At the 6-month follow-up, 21 patients had no pain, 6 had mild pain, and 3 had moderate pain. The mean Harris Hip Score was 83.1; functional outcome was excellent in 10 patients, good in 13, fair in 5, and poor in 2. The latter 2 were non-ambulatory; one of whom had sustained a periprosthetic fracture intra-operatively, which was managed by encerclage wiring, and the other had a neglected prosthetic dislocation at 3 months, which was converted to an excision arthroplasty. CONCLUSION: Bipolar hemiarthroplasty conferred good short-term outcome.

Simultaneous bilateral femoral neck stress fractures in a young military cadet: a rare case report.

Simultaneous bilateral femoral neck stress fracture in healthy young adult is one of the very rare clinical entities that an orthopedic surgeon may encounter once in lifetime. Bilateral femoral neck stress fractures have been very well documented in elderly and osteomalacia patients; however, its simultaneous occurrence in a healthy adult is challenging to diagnose and manage. This article describes a 34-year-old man a military personnel who sustained bilateral stress femoral neck fractures, during a routine training activity. The patient was come to our institution, and a full endocrine evaluation was performed and proved unremarkable. He underwent closed reduction and internal fixation of the fractures using cannulated screws on both the sides. At 1-year follow-up, the fractures went on to complete union. Despite strict non-weight-bearing instructions for initial 3-month period, patient bore weight on the limbs resulting in varus union on the left side. Our case emphasizes the significance of obtaining a complete and thorough medical history on physical examination and appropriately counseling patients regarding activity level even after successful fixation.