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A PROSPECTIVE STUDY OF COMPLICATIONS IN BIPOLAR HEMIARTHROPLASTY USING MODIFIED HARDINGE APPROACH IN THE MANAGEMENT OF FEMORAL NECK FRACTURES

Introduction: Fracture of femoral neck is on the rise in the recent years owing to the increase in the geriatric population, severe osteoporosis and increased brittleness of the bone with advancing age. Total hip replacement was mostly used in the initial days but owing to higher chances of dislocations, it is less preferred. Bipolar hemiarthroplasty has become one of the main methods of treatment. A variety of surgical approaches have been used. Posterior approach is the most preferred approach currently, followed by Hardinge approach. Complications like dislocation, infection and abductor lurch are still common with current approaches. This study was undertaken to show the functional outcomes of a Modified Hardinge approach which seems to have optimal results out of all the approaches. 
Aim: To evaluate the functional outcomes and complications of modified hardinge approach. 
Materials and Methods: A total of 20 patients with fracture neck of femur were taken into the study and treated with Bipolar Hemiarthroplasty using modified Hardinge approach between June 2018 and October 2019. Each patient was put through the same preoperative and postoperative protocols. They was screened for comorbidities and were taken up for surgery. Complications after this approach were evaluated post operatively for a period of 6 months. 
Results: The mean hip score was 80. Complications like posterior hip dislocation and infection were nil. Abductor lurch was not noted in any of the patients. One patient had infection out of 20 which was managed accordingly. 
Conclusion: Bipolar hemiarthroplasty through modified Hardinge approach can be used in the management of femoral neck fractures with lowest complication rate. Complications like posterior dislocation and abductor lurch were nil in the study. The only downside of the procedure being a longer learning curve makes it a less used approach compared to others. 
Keywords: Hemiarthroplasty, modified Hardinge approach, femoral neck fracture