title: Internal fixation or arthroplasty for displaced subcapital fractures in the elderly?
abstract: A series of 200 patients aged over 69 years admitted to this hospital with a non-pathological displaced subcapital fracture of the femur, have been studied prospectively. Approximately one-half were treated by internal fixation and the remainder by a hemiarthroplasty, the method of treatment being dictated by the preference of the on-call consultant. This has enabled a comparison between the two groups. At 1 year from injury there was no significant difference in the mortality or function of the survivors. Internal fixation resulted in fewer postoperative complications, a shorter hospital stay and a reduced cost of treatment. The reoperation rate for internal fixation was three times that after hemiarthroplasty. Despite the problem of non-union, this study suggests that internal fixation is the treatment of choice for displaced subcapital fractures in the elderly.
authors.affiliation: Birmingham Accident Hospital, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Parker
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000191:economics; D005599:Fractures, Ununited; D006622:Hip Prosthesis / Q000191:economics; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome