X-ref For other Roundups in this issue that cross-reference with Trauma see: Hip & Pelvis Roundup 1, 2, 8; Knee Roundup 6; Foot & Ankle Roundup 6; Research Roundup 7, 9.
Taper slip hemiarthroplasty for hip fracture X-ref
The hip fracture burden continues to rise, and as patients are becoming younger and younger, increasing attention is being paid to their functional demands. With many patients now receiving total hip arthroplasties, we were delighted here at 360 to read this paper concerning a modern hemiarthroplasty. Researchers in Peterborough (UK) report their retrospective evaluation of the largest consecutive series of the Exeter trauma stem.1 Patients were aged on average 81 years old, with a follow-up to 4.1 years (2 to 7). All patients were clinically followed up at six weeks with radiographs, then again at 12 months, with telephone consultations in the interim. Longer-term data were obtained from further telephone consultations, GP input and mortality statistics. Although 63% died during the follow-up period, as might be expected, only six of the survivors were lost to follow-up, making this an impressively robust report within the confines of a retrospective analysis. Of these patients, 24 ultimately required further surgery for implant-related complications, and at final follow-up, 71% of patients were living in their own home, and 42% were independently mobile with no need for walking aids, and had a low mean pain score of 1.6. At a time when choice of implant for intracapsular neck of femur fracture remains somewhat controversial, it is refreshing to see a study of a contemporary hemiarthroplasty prosthesis reporting excellent patient survivorship, favourable complication rates and good symptomatic and functional outcomes. Given the widespread popularity of the Exeter total hip arthroplasty, it is perhaps surprising that the equivalent hemiarthroplasty has gained relatively little international recognition; this study may potentially help to redress this.
Occult hip fractures X-ref