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Background <p>Restoring femoral offset (FO) and equalizing leg lengths are essential for optimal outcomes and preventing leg length discrepancy (LLD) in bipolar hemiarthroplasty (BHA) for femoral neck fractures (FNF) in elderly patients. However, evidence on the benefits of digital templating remains limited. This study evaluates the accuracy of a smartphone-based digital templating method for equalizing leg length and FO in BHA compared to the conventional intraoperative method.</p> Methods <p>A retrospective cohort study was conducted on 210 patients aged ≥ 60 years with FNF who underwent BHA between June 2018 and May 2023. The templating group (<i>n</i> = 70) used preoperative digital templating with Keynote presentation software on an iPhone, incorporating femoral prosthesis templates. The conventional group (<i>n</i> = 140) relied on intraoperative visual estimation, palpation, and the shuck test. Postoperative LLD and FO differences were assessed radiographically.</p> Results <p>The mean patient age was 74.9 ± 7.3 years (range: 60–95), with 180 (85.7%) women. The templating group achieved a mean LLD of 1.8 ± 3.5&#xa0;mm (range: -5.6 to 10.2&#xa0;mm), significantly better than 3.5 ± 5.5&#xa0;mm (range: -10.9 to 18.4&#xa0;mm) in the conventional group (<i>p</i> = 0.023). LLD within ± 6&#xa0;mm was observed in 87.1% (61 cases) of the templating group versus 59.3% (83 cases) in the conventional group (<i>p</i> &lt; 0.001). FO differences averaged 0.8 ± 2.6&#xa0;mm (range: -7.2 to 6.1&#xa0;mm) in the templating group, compared to -0.8 ± 3.7&#xa0;mm (range: -9.8 to 5.7&#xa0;mm) in the conventional group (<i>p</i> = 0.005). FO differences within ± 5&#xa0;mm occurred in 92.9% (65 cases) of the templating group versus 82.1% (115 cases) in the conventional group (<i>p</i> = 0.038).</p> Conclusions <p>The smartphone-based digital templating method using presentation software enhances the accuracy of leg length and FO equalization during BHA for elderly FNF patients, offering significant advantages over conventional techniques.</p> Level of evidence <p>III.</p>

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Smartphone-based digital templating using presentation software enhances accuracy in equalizing leg length and femoral offset during bipolar hemiarthroplasty for femoral neck fracture

  • 期刊论文

  • 发表日期：

    2025年7月15日

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  • Anuwat Pongkunakorn,
  • Siravat Teerasukakul,
  • Siripong Tahwang,
  • Wongsapat Prayatkul

摘要

Background

Restoring femoral offset (FO) and equalizing leg lengths are essential for optimal outcomes and preventing leg length discrepancy (LLD) in bipolar hemiarthroplasty (BHA) for femoral neck fractures (FNF) in elderly patients. However, evidence on the benefits of digital templating remains limited. This study evaluates the accuracy of a smartphone-based digital templating method for equalizing leg length and FO in BHA compared to the conventional intraoperative method.

Methods

A retrospective cohort study was conducted on 210 patients aged ≥ 60 years with FNF who underwent BHA between June 2018 and May 2023. The templating group (n = 70) used preoperative digital templating with Keynote presentation software on an iPhone, incorporating femoral prosthesis templates. The conventional group (n = 140) relied on intraoperative visual estimation, palpation, and the shuck test. Postoperative LLD and FO differences were assessed radiographically.

Results

The mean patient age was 74.9 ± 7.3 years (range: 60–95), with 180 (85.7%) women. The templating group achieved a mean LLD of 1.8 ± 3.5 mm (range: -5.6 to 10.2 mm), significantly better than 3.5 ± 5.5 mm (range: -10.9 to 18.4 mm) in the conventional group (p = 0.023). LLD within ± 6 mm was observed in 87.1% (61 cases) of the templating group versus 59.3% (83 cases) in the conventional group (p < 0.001). FO differences averaged 0.8 ± 2.6 mm (range: -7.2 to 6.1 mm) in the templating group, compared to -0.8 ± 3.7 mm (range: -9.8 to 5.7 mm) in the conventional group (p = 0.005). FO differences within ± 5 mm occurred in 92.9% (65 cases) of the templating group versus 82.1% (115 cases) in the conventional group (p = 0.038).

Conclusions

The smartphone-based digital templating method using presentation software enhances the accuracy of leg length and FO equalization during BHA for elderly FNF patients, offering significant advantages over conventional techniques.

Level of evidence

III.