Abstract:

BACKGROUND: Most femoral neck fracture patients with lower limb length discrepancy have experienced long-term traction or failure internal fixation, the hip has severe osteoporosis, soft tissues around the hip joint and joint capsules contracture or avascular necrosis as well as the lower limb length discrepancy, so the clinical treatment is difficult.
OBJECTIVE: To explore the clinical effect of total hip arthroplasty for treatment of old femoral neck fracture complicated with limp length discrepancy.
METHODS: Thirty-five cases of old femoral neck fractures with lower limb length discrepancy were treated with total hip arthroplasty. Skeletal traction on the femoral condyle and the X-ray measurement of both lower extremities and pelvis were prepared preoperatively, it was done to anticipate for the level of femoral neck osteotomy and the level of loosing up tissue around hip joint, as well as to adjust the length of the prosthesis head and neck in order to maintain the length of the limbs during surgery.
RESULTS AND CONCLUSION: Results of the 6 patients with shortened limb ranging 3.0-4.0 cm preoperartively, only 1 case had limb length discrepancy in 1 cm after surgery, as for the rest 5 cases and 29 patients with shortened limb ranging 1 to 2 cm preoperatively, none limb had been shortened postoperatively compared with its contralateral limb. According to Harris score system, the mean preoperative Harris score was significantly improved after 1 year postoperatively (P < 0.05). Total hip replacement can recover hip function rapidly and steady with a high good rate and satisfactory short term effect. Therefore, total hip arthroplasty is a very important and an effective treatment method for old femoral neck fracture with limp length discrepancy．