Impact of Delayed Presentation on the Outcome of Hemiarthroplasty in Elderly Patients with Fractured Neck of the Femur in a Low-resource Setting

Abstract Background: The neck of femur (NOF) fracture is a prevalent fracture among the elderly following a trivial fall and has been linked to higher morbidity and mortality if treatment is delayed. Objectives: This study compared the early outcomes of hemiarthroplasty between two groups based on the time of presentation and surgery. Materials and Methods: A retrospective cohort study was conducted at a tertiary orthopaedic centre involving elderly patients (>60 years old) who had hip hemiarthroplasty for NOF fracture. A total of 84 patients met the inclusion criteria and were divided into two groups: 30 patients who had surgery within one week of injury were grouped as ‘early’, and 54 patients who had surgery after one week of injury were categorised as ‘delayed’. Outcome variables compared were duration of surgery, blood loss, return to pre-injury ambulation, length of hospital stay and early complications. Results: There was no significant difference between the two groups with respect to the mean duration of surgery, blood loss and length of hospital stay ( P > 0.05). Although there was increased mortality, intraoperative fractures and delayed return to the pre-morbid walking status in the delayed group, the difference was not statistically significant. Conclusion: We observed that delayed presentation with cut-off of seven days had no significant impact on the perioperative outcome following hip hemiarthroplasty in elderly patients with NOF fractures. Emphasis should be placed on surgical techniques, rehabilitation and shortened hospital stays.