title: Early revision after hemiarthroplasty and osteosynthesis of cervical hip fracture: short-term function mortality unchanged in 102 patients.
abstract: BACKGROUND
  There is no consensus on whether osteosynthesis or hemiarthroplasty is preferable in the treatment of cervical hip fractures. Osteosynthesis is associated with more reoperations than hemiarthroplasty but there is little information available on the consequences of these reoperations.
  
  
  METHODS
  We studied the effect on mortality, hospital stay and functional outcome of revision performed within 4 months of primary surgery with hemiarthroplasty or osteosynthesis for cervical hip fracture. 50 (6%) of 792 patients treated with uncemented Austin-Moore hemiarthroplasty and 52 (13%) of 411 patients with osteosynthesis (86 with two hook pins and 325 with three cannulated screws) had had revision surgery. Control groups matched for age, sex, residential status, walking ability at fracture, type of primary operation and fracture type consisted of patients who had not had a reoperation.
  
  
  RESULTS
  Reoperation impaired walking ability and was associated with increased use of walking aids at 4 months in the hemiarthroplasty group and the osteosynthesis group as compared to controls, but did not have any statistically significant effect on residential status. In the hemiarthroplasty group, 4-month mortality was 12% among the reoperated patients and 18% among the controls, while mortality at 1 year was 24% in both groups. The corresponding figures in the osteosynthesis group and controls were 6% and 6% at 4 months, respectively, and 17% and 13% at 1 year.
  
  
  CONCLUSIONS
  To some extent, reoperation impairs early functional outcome after cervical hip fracture treated by either osteosynthesis or hemiarthroplasty, but does not increase mortality to any significant degree.
authors.affiliation: Department of Orthopaedic Surgery, University of Oulu, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Sipilä
authors.forename: Pekka
authors.initials: P
authors.lastname: Hyvönen
authors.forename: Juha
authors.initials: J
authors.lastname: Partanen
authors.forename: Jukka
authors.initials: J
authors.lastname: Ristiniemi
authors.forename: Pekka
authors.initials: P
authors.lastname: Jalovaara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality / Q000601:surgery*; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors