Surgical Management of Hip Fractures: An Evidence-based Review of the Literature. I: Femoral Neck Fractures

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

“…Higher reoperation rates have been associated with the use of fixation in FNFs [5,18,21,22,37,39,43,45] resulting in a more costly treatment than hemiarthroplasty [1,25]. Other associated risks of fixation include increased contralateral hip fractures [49] and complications and technical difficulties associated with salvage of failed fixation [16,23,34]. Despite the higher reoperation rates for internal fixation, advocates of this procedure argue this risk is offset by the benefits of preservation of the native femoral head and avoidance of potential complications of arthroplasty [2,13,31].…”

“…The use of internal fixation in FNFs has been associated with reoperation rates ranging from 10% to 49% [18,21,22,24,42,44] compared with 0% to 24% for hemiarthroplasty [5,18,36,44], resulting in a more costly treatment strategy than hemiarthroplasty [1,25]. Despite increased complications and technical difficulties associated with salvage of failed fixation [16,23,34], some argue the higher reoperation rate is offset by the benefits of preservation of the native femoral head and avoidance of potential complications associated with arthroplasty [2,13,31]. Mortality at 1 year ranges from 14% to 36% but without differences in mortality between fixation and hemiarthroplasty at 1, 5, and 10 years [8,18,19,31,36,37].…”

Total hip replacement for neck of femur fracture: Comparing outcomes with matched elective cohort

“…When considering a displaced NOF#, the treatment options and outcomes become more uncertain (10). Fisher et al performed a retrospective analysis on 3,423 patients aged ≥ 65 years with NOF# treated with open reduction internal fixation, HA and THR; and concluded that there were no difference in the 30-days mortality rate (11).…”

Functional Outcome after Partial Hip Replacement for Femoral Neck Fracture (Subcapital Fracture) with Austin Moore Prosthesis

“…The adoption of either a surgical or nonsurgical approach requires a multifactorial decision that incorporates the patient's pre-injury status, including prior hip pain, ambulation, functional and mental capacity, and the complexity of their medical background [1]. Neck and Intertrochanteric fractures of the femur, as opposed to femoral shaft fractures, have a very low incidence of immediate life threatening complications such as blood loss or fat emboli.…”

“…Femoral neck fractures of the hip are very common intracapsular fracture at old age, and occur most commonly in women older than age 65 years [1,2]. This fracture poses a significant health care problem, with a worldwide annual incidence of approximately 1.7 million which is expected to triple in the next 50 years as the population ages [3,4].…”