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FEMUR FRACTURES (Femoral shaft (Mechanism (high energy trauma,), Clinical…

- - - - Advantages
        
        allows immediate weight-bearing to return elderly patients to activity and help avoid complications of inactivity
        
        eliminates avascular necrosis and nonunion
        
        reduces the incidence of reoperation compared to internal fixation
      - Selection of Prosthesis
        
        Hemiarthroplasty
        
        Austin Moore’a, Bipolar
        
        Indications:
        1.Age >75 years old.
        2.A fracture that cannot be satisfactorily reduced or fixed with
        stability, especially with posterior comminution.
        3.Necessity of immediate weight-bearing after surgery
        4.Femoral neck fractures that lose fixation several weeks after operation.
        5.Some preexisting lesions of the hip.
        6.Malignancy.
        7.Neurologic disorders
        8.Old, undiagnosed fractures of the femoral neck.
        9.Fracture of the neck of the femur with complete dislocation of the femoral head.
        10.Patients with psychoses or mental deterioration.
        
        Total Hip Arthroplasty (cemented, noncemented)
        
        Indications:
        1.A fresh unstable femoral neck fracture
        2.Age > 50 years old
        3.Necrosis of femoral head
        4.Nonunion of femoral neck
        5.Complications after Hemiarthroplasty
        6.Coxarthrosis
        7.Pathological femoral neck fractures
        
        PROSTHESIS PERSISTENCE : 10 – 20 years