Early outcomes of Bipolar hemiarthroplasty for displaced femoral neck fractures in a resource-limited referral hospital in the Republic of Congo: A retrospective case series

Résumé fourni par la source

Introduction: Bipolar hemiarthroplasty is a commonly used treatment for displaced femoral neck fractures in older patients. In resource-limited countries, however, access to this procedure remains restricted, particularly outside university hospitals. This study aimed to evaluate the early outcomes of bipolar hemiarthroplasty performed in a public referral hospital in the Republic of Congo. Methods: This retrospective observational case series was conducted at Talangaï Referral Hospital, Brazzaville, between March 2023 and January 2026. Patients with displaced femoral neck fractures (Garden III or IV) treated with primary cemented bipolar hemiarthroplasty were included. All procedures were performed under spinal anesthesia through a posterior Moore approach. Full weight-bearing was initiated on the first postoperative day. Functional outcome was assessed using the Merle d’Aubigné and Postel (PMA) score. Results: Thirteen patients were included. The mean age was 74.8 ± 11.6 years, and nine patients (69.2%) were women. The mean time to surgical management was 45 days. Mean operative time was 120 minutes, mean estimated blood loss was 250 mL, and mean postoperative hospital stay was 5 days. One prosthetic dislocation (7.7%) requiring revision surgery occurred. One sudden postoperative death (7.7%), with clinical suspicion of pulmonary embolism, was observed. The mean PMA score was 14.5, corresponding to an overall good functional outcome. Conclusion: Cemented bipolar hemiarthroplasty appears feasible in a resource-limited public referral hospital, with satisfactory early functional outcomes. Expanding access to this procedure outside university hospitals may contribute to improving hip fracture care in sub-Saharan Africa.

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