TITLE:
Femoral Neck Fractures in the Elderly: Short-Term Treatment Outcome Using Unipolar Hemiarthroplasty at Muhimbili Orthopedic Institute
AUTHORS:
Ramadhan N. Ngalawa, Antony B. Assey, Paul E. Ndeki, Benard F. Ntiyakama, Muhaji K. Mohammed, Fatma J. Sitta, Deus J. Nzella, David J. Mwasota, Gilbert G. Waria
KEYWORDS:
Femoral Neck Fracture, Elderly Patients, Unipolar Hemiarthroplasty, Short-Term Treatment Outcome, Hip Arthroplasty, Muhimbili Orthopedic Unit
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.16 No.5,
May
15,
2026
ABSTRACT: Background: A femoral neck fracture in the elderly is commonly due to osteoporosis and a simple fall for various reasons such as visual disturbance. Most of these patients have osteoporosis and co-morbidities, thus posing great challenges to their management. Moreover, there are different treatment options for elderly patients with femoral neck fractures depending on the age of the patient (physiologically old or physiologically young), fracture pattern, and degree of displacement. At MOI, unipolar hemiarthroplasty is one of the commonly used treatment modalities for femoral neck fractures in the elderly. Objectives: To determine the short-term treatment outcome of elderly patients with femoral neck fractures treated using unipolar hemiarthroplasty at MOI from July 2017 to April 2018. Methodology: A cross-sectional study was conducted on elderly patients aged 60 years or above with femoral neck fractures and treated using unipolar hemiarthroplasty. The study was conducted at MOI for a period of ten months from July 2017 to April 2018. Thirty-three patients met the inclusion criteria and were recruited into the study. They were followed up for a period of three months post-surgery. Three patients were excluded late in the study after being noted to develop metastatic carcinoma and died before completion of the follow-up period. These patients were reviewed in follow-up clinics, and at the 12th week post-surgery, ambulatory status was assessed using the Cumulative Ambulation Score (CAS) in a structured questionnaire. Results: Thirty-three patients with femoral neck fractures were enrolled. Of these patients, three patients died during the course of follow-up. Thirty patients with femoral neck fracture were followed for at least 3 months and they were analyzed. The proportion of femoral neck fractures among all femur fracture patients attended to at MOI was 17.9%. Among enrolled patients, the majority were female, accounting for 60%. The mean age of participants was 67.5 years. Two patients developed dislocation post-surgery, accounting for 6.7%. Postoperative ambulatory status was assessed using the Cumulative Ambulation Score. Twenty-six patients (86.7%) showed independence in basic activities (i.e., getting in and out of bed, sit-stand-sit from a chair, and walking) as the minimum criteria in order to go home. Four patients (13.3%) had a low CAS, meaning they had poorer mobilization. Conclusion and Recommendation: Hemiarthroplasty in elderly patients with femoral neck fractures had an excellent cumulative ambulation score. The study shows a low dislocation rate and a low infection rate post hemiarthroplasty. Patients who are ≥60 years and physically less demanding will benefit from hemiarthroplasty.