Treatment of displaced intracapsular hip fractures in elderly patients

doi:10.1136/bmj.39392.353090.80

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 ratethan internal fixation

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

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

Numerous reports of case series and some methodologically weakrandomised controlled trials have failed to resolve the questionof which treatment is best, and different surgeons tend to favourone or the . . . [Full text of this article]

Martyn Parker, research fellow

¹ Peterborough District Hospital, Peterborough PE3 6DA

martyn.parker@pbh-tr.nhs.uk

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