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Internal fixation compared with total hip replacement for displaced femoral neck fractures: A minimum fifteen-year follow-up study of a previously reported randomized trial
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
2014 (English)In: Journal of Bone and Joint Surgery. American volume, ISSN 0021-9355, E-ISSN 1535-1386, Vol. 96, no 6, e46.1-e46.6 p.Article in journal (Refereed) Published
Abstract [en]

Background: Prospective randomized studies comparing internal fixation and a cemented hip replacement in the treatment of displaced femoral neck fractures have shown favorable short-term results for prosthetic replacement. The present report compares the results after a minimum of fifteen years. Methods: From 1994 to 1998, 143 patients (146 hips) were randomized to closed reduction and internal fixation with two screws (n = 78) or a cemented total hip replacement (n = 68). The average age of the patients was eighty-four years (range, seventy-five to 101 years), and 38% were classified as mentally impaired. Failure after internal fixation was defined as early redisplacement, nonunion, symptomatic segmental collapse, or deep infection. In the arthroplasty group, failure was defined as two dislocations or more, implant loosening, deep infection, or a periprosthetic fracture. Results: For the lucid patients, the failure rate was 55% after internal fixation compared with 5% after total hip replacement. For patients with mental impairment, it was 16% in both groups. Conclusions: Total hip replacement is superior to internal fixation in the treatment of a displaced femoral neck fracture. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Place, publisher, year, edition, pages
Journal of Bone and Joint Surgery, Inc , 2014. Vol. 96, no 6, e46.1-e46.6 p.
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URN: urn:nbn:se:liu:diva-110520DOI: 10.2106/JBJS.K.00244ISI: 000352322000003PubMedID: 24647513ScopusID: 2-s2.0-84896958225OAI: diva2:748105
Available from: 2014-09-18 Created: 2014-09-12 Last updated: 2015-06-01

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Johansson, Torsten
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Orthopaedics in Linköping
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