[Bipolar hemiarthroplasty for the treatment of femoral neck fractures and the effect of surgical approach on functional results].

Objectives: This study aimed to evaluate the effect of an anterior versus posterior surgical approach for bipolar hemiarthroplasty on postoperative functional results of patients treated for femoral neck fractures.

Patients And Methods: Among the 196 patients over the age of 65 treated with cemented bipolar prosthesis for femoral neck fracture in our clinic between May 2000 and November 2008, 76 patients who followed up for at least one-year were retrospectively evaluated. The average follow-up period was 18.7 months (range 12 to 40 months). All fractures were Garden's type III or IV. The patients were divided into two groups according the surgical approach: posterior in 52 patients (Group 1; 25 males, 27 females; mean age 73.8 years; range 65 to 88 years) and anterior in 24 patients (Group 2; 14 males, 10 females; mean age 71.4 years; range 67 to 94 years). Cement was applied by hand in 62 cases and with a cement gun in 14 cases.

Results: Mean Harris scores were 84.7±10.3 in group 1 and 85.8±7.1 in group 2. According to the Harris scoring system, the results were very good in 26 cases; good in 40 cases; fair in six cases; and poor in four cases. While early dislocation was observed in 9.6% of patients with the posterior approach, it was not observed in any patients treated with the anterior approach. There was no significant difference with regard to functional scores or early dislocations between group 1 compared to group 2 (p>0.05).

Conclusion: Based on our results, bipolar prothesis is an appropriate and effective treatment option for patients with femoral neck fracture to obtain early return to daily activity. The surgical approach does not affect the functional results. Although not statistically significant, it was concluded that the anterior approach is more reliable for early dislocation.