Hemiarthroplasty in Intracapsular
Femoral Neck Fractures
Bartoníček J., Skála-Rosenbaum J., Džupa V., Svatoš F., Bartoška R.
Ortopedicko-traumatologická klinika, 3. LF UK a FNKV, Praha-Vinohrady, přednosta: prof. MUDr. J. Bartoníček, DrSc. |
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Summary:
Hemiarthroplasty has still its place in the therapeutic algorithm of the treatment of dislocated intracapsular femoral neck
fractures. As compared to internal fixation it is accompanied by less complications and allows an immediate postoperative
weight bearing. In contrast to total hip arthroplasty, this operation is not so demanding for the patient. However in the longterm
perspective it is often associated with erosion of acetabulum. Therefore it is indicated mainly for biologically older patients
with less physical activity without osteoarthritis of the hip. In these patients we usually prefer a cemented monoblock
hemiarthroplasty. In case of biologically younger patients where it is impossible to use total hip arthroplasty due to general or
local condition, modular hemiarthroplasty is indicated with a removable head allowing in case of acetabular erosion an easy
conversion to total hip arthroplasty. Hemiarthroplasty must be correctly indicated and technically properly performed. First of
all it is necessary to respect the relation between the centre of the prosthetic head and the apex of the greater trochanter, i.e.
the head centre should be 1-2 mm below the level of apex of the greater trochanter. Further, it requires a correct anteversion
and suture of the articular capsule as a prevention of postoperative dislocation.
Key words:
intracapsular femoral neck fractures, hemiarthroplasty, proximal femur fractures
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