الفهرس 
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Abstract
The aim of this essay is to:
Study of literatures, about the using of modular unipolar hip prosthesis in treatment of femoral neck fracture and comparing it and other devices in treating such fracture.
Summary and Conclusion
Fractures of the neck of the femur have always presented great challenges to orthopaedic surgeons and remain in many ways today the unsolved fracture as far as treatment and results are concerned. Femoral neck fractures are common in elderly patients. With life expectancy increasing with each decade, the society is becoming more and more a geriatric society, with significant numbers of hospitalized and nursing home patients suffering from femoral neck fractures and their sequelae (122).
It appears that certain parameters in the treatment of fracture neck of femur such as the need for second operations at patient’s age over 60 or 65 years old, would guide surgeons toward an arthroplasty over internal fixation for a displaced fracture. Cannulated screw fixation of such fractures in this age group is associated with poorer outcomes. Instead, prosthetic replacement is the treatment of choice (3).
Some controversy surrounds which prosthesis (unipolar, bipolar or THR) is better in the management of these fractures. The current attitude with displaced femoral neck fractures is to treat them by hemiarthroplasty which is highly indicated in patients over 60 or 65 years old, the bone quality is poor, and the fracture is displaced, and in patients who are occasionally active outside the home (146).
Hemiarthroplasty gives a better range of motion, less operation time and low cost compared to THA in patients with acute femoral neck fracture with healthy acetabulum. On the other hand, Total hip replacement should be considered in the case of acute displaced femoral neck fractures in previously active elderly individuals with acetabular articular cartilage changes, other indications may include preexisting hip disease (rheumatoid arthritis, Paget´s disease) (169).
With the development of endoprostheses (bipolar, modular unipolar femoral heads) the use of fixed head endoprostheses (Monoblock (conventional) unipolar prosthesis) has declined (122).
The significant differences between the modular and the conventional types are: ( 6)
- The neck length of the component can be adjusted to tension the abductors muscles.
- The previous advantage theoretically decreases the stress on the acetabular cartilage.
- If required, the offset of the femoral neck can be adjusted without increasing the leg length.
- The modular implant can be more easily converted to a total hip replacement.
Either bipolar or modular unipolar hemiarthroplasty may be offered as alternative treatments for a displaced intracapsular fracture of the proximal femur in elderly patients. The incidence of the acetabular erosion in the unipolar group may demonstrate the theoretical benefit of the bipolar prosthesis, although the differences were not statistically significant (167).
There are also no significant differences in the rates of postoperative complications or dislocation, and quality of life or functional outcome scores between the two groups. So there is no advantage to use bipolar endoprostheses in treating of femoral neck fracture in elderly patients. Furthermore, the lower cost of modular unipolar compared with bipolar endoprostheses provides additional support for the use of the former (165).