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Link
http://www.jbjs.org.uk/cgi/content/abstract/67-B/2/214
Primary total hip replacement for
displaced subcapital fractures of the femur
By: WH Taine and PC Armour
The management of displaced subcapital fracture of the hip is
still controversial because of the high incidence of
complications after internal fixation or hemiarthroplasty. To
avoid some of these complications we have used primary total hip
replacement for independently mobile patients over 65 years of
age. A total of 163 cases, operated on over four years, have
been reviewed. There were relatively more dislocations after
operation for fracture than after total replacement for
arthritis, and these were associated with a posterior approach
to the hip. Only seven revision operations have been required.
Of 57 patients who were interviewed an average of 42 months
after replacement, 62% had excellent or good results as assessed
by the Harris hip score. All the others had major systemic
disease which affected their assessment. This inadequacy of
current systems of hip assessment is discussed. It is concluded
that total hip replacement is the best management for a selected
group of patients with this injury, and that further prospective
studies are indicated.
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