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On the basis of the case histories of 45 subcapital fractures of the femoral neck treated by hip arthroplasty (endoprothesis) indication and long-term results are demonstrated (average period after operation 54 months, longest period 16 years). Late complications (acetabular erosion, loosening) and possibilities to prevent them are discussed.
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In 29 patients with fractures of the femoral neck (group A) and 22 patients operated on for osteoarthritis of the hip (group) B), plasma levels of 25-hydroxycholecalciferol (25-OH-D3) were compared with the results of histological bone tests. A third group of 19 patients at the Geriatric hospital served as a control in this age group for 25-OH-D3 values (group C). The average level of 25-OH-D3 was 9.64 +/- 5.8 micrograms/l in group A and 13.25 +/- 7.6 micrograms/l in group B. This difference is not significant. On the other hand, the difference between groups B and C (9.31 +/- 4.04) is significant (2 p less than 0.05). Evaluation of the histological sections did not reveal evidence of osteomalacia. Generally speaking, the levels of plasma 25-OH-D3 in these patients were low, but without signs of osteomalacia on histological evaluation.
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1000 operative treatments of fractured neck of the femur in hospital in 25 years were analyzed. In addition to a rise in frequency of admission, a progressive aging of the patients was observed. The operative technique developed into osteosynthesis, principally with the Pugh nail and hip joint alloplasty. 19% of the patients died.
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