Serkan Surucu1, Mahmud Aydin2, Mehmet Bugrahan Gurcan3, Sahan Daglar2, Fazlı Levent Umur4

1Department of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, United States
2Department of Orthopedics and Traumatology, Haseki Training Research Hospital, Istanbul, Türkiye
3Department of Psychiatry, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul, Türkiye
4Department of Orthopedics and Traumatology, Acıbadem Hospital, Istanbul, Türkiye

Keywords: Cognitive dysfunction, elderly patients, hemiarthroplasty, Mini-Mental State Examination, proximal femoral nailing.


Objectives: This study aims to compare the effects of hemiarthroplasty (HA) and proximal femoral nailing (PFN) on postoperative cognitive function in elderly adults with hip fractures.

Patients and methods: Between August 2021 and January 2022, a total of 49 patients (28 males, 21 females; mean age: 78.1±9.4 years; range, 65 to 96 years) presented with a proximal femoral fracture were included. The patients were divided into two groups based on the type of surgical technique used. Group 1 consisted of 23 patients who underwent cemented HA, while Group 2 consisted of 26 patients who underwent osteosynthesis with a PFN. Preoperatively (24 h before surgery), within the first week (Days 4 to 7), and at one month following surgery, the MiniMental State Examination (MMSE) was applied.

Results: The surgery side and duration of surgery were not significantly different between the two groups (p>0.05); however, the length of hospital stay and estimated blood loss were significantly different (p<0.001) in favor of Group 2. When the decline in MMSE scores from preoperative to postoperative was assessed, it was shown that group 2 had a lesser decrease.

Conclusion: Patients with hip fractures who underwent PFN surgery experienced less postoperative cognitive impairment than those who underwent HA surgery.

Citation: Surucu S, Aydin M, Gurcan MB, Daglar S, Umur FL. The effect of surgical technique on cognitive function in elderly patients with hip fractures: Proximal femoral nailing versus hemiarthroplasty. Jt Dis Relat Surg 2022;33(3):574-579.

Ethics Committee Approval

The study protocol was approved by the Haseki Training and Research Hospital Ethics Committee (date: 08.04.2021, no: 314). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept: S.S., M.A., M.B.G.; Design: S.S., M.A.; Data collection/processing: M.A., S.D.; Analysis/interpretation: M.B.G., F.L.U.; Literature review: S.S., M.A., M.B.G.; Drafting/writing: S.S., M.A., M.B.G.; Critical review: S.S., F.L.U.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.