Hip hemiarthroplasty for femoral neck fractures using the modified stracathro approach - Short term results in twenty-six patients

Abstract

Background and Objective : The Stracathro approach to the hip is a modification of the lateral approach, which was popularized by Hays and McLauchlan. It has a high safety profile and a low rate of hip dislocation. However, the need for osteotomy increases blood loss, risk of intraoperative fracture, and postoperative heterotopic calcification. In sub-Saharan Africa, where traditional healers dabble in the treatment of all musculoskeletal conditions, extensive soft tissue contractures and disuse osteoporosis arise and further complicate the lateral approach. The objective of this article is to highlight modifications made to the stracathro approach and present the short-term results in a group of 26 patients, who had hemiarthroplasty using this technique. Materials and Methods: All patients presenting with subcapital or transcervical fracture of the femoral neck after the age of 50 years were offered hemiarthroplasty using the modified Stracathro approach, with follow-ups for a period ranging from 28 - 84 months. Results: A majority (23 out of 26 - 88.5%) of patients presented late for the treatment, due to the patronage of traditional bonesetters. In spite of the soft tissue contractures and osteoporosis associated with late presentation, there was no case of intraoperative fractures. The patients had good hip abduction postoperatively. In addition, there was no intraoperative nerve or vascular injury. Conclusion: The short-term results in this group of patients showed that the modified Stracathro approach was safe and useful in hemiarthroplasty, for patients with soft tissue contracture and osteoporosis.