title: [Fracture arthroplasty of femoral neck fractures].
abstract: A paradigm shift in the treatment of elderly patients has recently taken place leading to an increase in joint replacement surgery. The aim of this article is to highlight new developments and to present a treatment algorithm for femoral neck fractures. The age limit must be individually determined considering the comorbidities and perioperative risk profile. Pertrochanteric femoral fractures are nearly exclusively treated by osteosynthesis regardless of age. The situation for femoral neck fractures is more complex. Patients younger than 65 years should generally be treated by osteosynthesis but patients older than 65 years benefit from hemiarthroplasty or total hip arthroplasty. In patients aged between 65 and 75 years with high functional demands and a justifiable perioperative risk, total joint replacement is the treatment of choice. In physically less active patients older than 75 years and poor general condition, preference should be given to hemiarthroplasty.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland. karl.braun@mri.tum.de.
authors.forename: K F
authors.initials: KF
authors.lastname: Braun
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Hanschen
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Biberthaler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D019317:Evidence-Based Medicine; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D062785:Hemiarthroplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroplasty, replacement, hip; Bone cements; Comorbidity; Hemiarthroplasty; Prosthesis design