BMJ  2007;335:1220-1221 (15 December), doi:10.1136/bmj.39392.353090.80 (published 4 December 2007)

Editorials

Treatment of displaced intracapsular hip fractures in elderly patients

Arthroplasty improves function and has a lower reoperation rate than internal fixation

The first 150 words of the full text of this article appear below.

Displaced fracture of the intracapsular proximal femur has been termed the "unsolved fracture" because it is unclear whether it should be treated by internal fixation or by replacement of the femoral head with an artificial hip (arthroplasty).¹ More than a third of fixed fractures will require revision surgery for either redisplacement (a complication of fracture healing), fracture non-union, or avascular necrosis of the femoral head. Arthroplasty, however, is a more extensive surgical procedure and may cause dislocation, loosening, and peri-prosthetic fracture, which together have an overall incidence of 5-15%. In their randomised controlled trial in this week’s BMJ, Frihagen and colleagues compare the effects of internal fixation or bipolar hemiarthroplasty after displaced fracture of the femoral neck.

Numerous reports of case series and some methodologically weak randomised controlled trials have failed to resolve the question of which treatment is best, and different surgeons tend to favour one or the . . . [Full text of this article]

¹ Peterborough District Hospital, Peterborough PE3 6DA

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Reasons for optimism

Rajendra Kale
BMJ 2007 335: 0. [Extract] [Full Text]

Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial

Frede Frihagen, Lars Nordsletten, and Jan Erik Madsen
BMJ 2007 335: 1251-1254. [Abstract] [Full Text] [PDF]