Profile of Fracture Neck of Femur in a Nigerian Regional Hospital

Abstract

Background: Fractures of the neck of the femur may occur in the elderly, the middle aged or the young. Although the predisposing factors differ across the age categories, the real burden of fracture neck of femur with respect to morbidity, and perhaps mortality, resides with the elderly population. The aim of this paper is to present the profile of fracture neck of femur among patients seen in one of the three regional Orthopaedic hospitals in Nigeria.
Methods: A retrospective review of fractures of the neck of the femur treated at a regional orthopaedic hospital in Nigeria, from January 2009 to December 2013, is presented.
Results: A total of 126 patients were studied. The mean age was 62years. 45(35.7%) of the cases occurred at 60 years or below in a male to female ratio of approximately 3:1, whereas 81(64.3%) occurred after 60 years in a male to female ratio of 1:1.5. Eighty-three (65.9%) occurred following domestic accident, with 76(91.6%) of the domestic accident occurring in patients over 50 years. Basal cervical (53.3%) and Transcervical (52.3%) fractures were more common in males, whereas subcapital fractures (52.6%) were more common in females. The overall rate of Basal cervical,
Transcervical and Subcapital fractures were 40.7%, 41.7%and 17.6% respectively. Also, Garden type 4 fracture (61.4%) was more common in males, whereas Garden type 3 (66.7%) was more common in females. The overall rate of Garden type 4 and 3 fractures was 72.2% and 22.8% respectively, whereas that of Garden type 1 and 2 was 3.8% and 1.3% respectively. The mean duration between injury and hospitalisation was 40.5days (5.8weeks). 113(89.7%) patients were managed operatively, with hemiarthroplasty (59.3%) as the most common procedure done. The remaining 13(10.3%) patients were managed non-operatively.
Conclusion: The mechanism of fracture neck of femur differs according to age of the patient. The gender distribution of this injury is tilted towards male preponderance before the age of 60 years, and towards female preponderance after 60 years.

Keywords: Neck of femur, fracture, Nigeria