Evaluation of internal fixation of fracture neck of femur above 60 years of age based on selection using physiological status score

Introduction: Hip fractures are relatively common injuries in adults and are associated with substantial mortality and morbidity, especially in the elderly. While patients above 60 years are considered for arthroplasty, the study focuses on evaluating internal fixation in carefully selected patients of this age group. Aim: This study is aimed at evaluation of clinicoradiological and functional outcomes of fixing femoral neck fractures in a selected elderly population. Material and methods: The study included 36 cases of fracture neck of femur above 60 years of age treated by closed reduction and internal fixation. Dual-energy x-ray absorptiometry (DEXA) was done preoperatively and those with Physiologic Status Score (PSS) more than 20 were included in the study. Results: In our study 75% of the patients had an excellent Harris hip score while it was good in 11.11%, fair in 8.33% of the patients and poor in the remaining 5.55% of the patients. Non-union of femoral neck fracture occurred in 4 cases (11.11%) while osteonecrosis were observed in 3 patients (8.3%). The eldest patient operated was 85 years of age. Conclusion: Internal fixation maybe considered as mode of treatment in carefully selected patients over 60 years also with favourable outcomes. PSS is a useful tool in selecting such patients.