Clinical outcome after undisplaced femoral neck fractures
Open Access
- 30 May 2011
- journal article
- Published by Medical Journals Sweden AB in Acta Orthopaedica
- Vol. 82 (3), 268-274
- https://doi.org/10.3109/17453674.2011.588857
Abstract
Little attention has been paid to undisplaced femoral neck fractures. By using data from the Norwegian Hip Fracture Register, we investigated the risk of reoperation and the clinical outcome after treatment of these fractures in patients over 60 years of age. Data on 4,468 patients with undisplaced femoral neck fractures who were operated with screw osteosynthesis were compared to those from 10,289 patients with displaced femoral neck fractures treated with screw osteosynthesis (n = 3,389) or bipolar hemiarthroplasty (n = 6,900). The evaluation was based on number of reoperations and patient assessment at 4 and 12 months of follow-up. The 1-year implant survival was 89% after screw fixation for undisplaced fractures, 79% after screw fixation for displaced fractures, and 97% after hemiarthroplasty for displaced fractures. Patients with displaced fractures who were operated with internal fixation had a higher risk of reoperation (RR = 1.9, CI: 1.7–2.2), reported more pain, were less satisfied, and had lower quality of life than patients with undisplaced fractures treated with internal fixation (p < 0.05). Patients with displaced fractures who were operated with hemiarthroplasty had a lower risk of reoperation than patients with undisplaced fractures who were operated with internal fixation (RR = 0.32, CI: 0.27–0.38). Furthermore, they had the lowest degree of pain, were most satisfied, and reported the highest quality of life. Interpretation The differences in clinical outcome found were less than what is considered to be of clinical importance. The results support the use of screw osteosynthesis for undisplaced femoral neck fractures in elderly patients, although even better results were obtained in the hemiarthroplasty group in patients with displaced fractures.Keywords
This publication has 21 references indexed in Scilit:
- Undisplaced femoral neck fractures—no problems? A consecutive study of 224 patients treated with internal fixationInjury, 2009
- Fixation versus hemiarthroplasty for undisplaced intracapsular hip fracturesInjury, 2008
- Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trialBMJ, 2007
- Outcome of undisplaced and moderately displaced femoral neck fracturesActa Orthopaedica, 2007
- Total Hip Arthroplasty and Hemiarthroplasty in Mobile, Independent Patients with a Displaced Intracapsular Fracture of the Femoral NeckThe Journal of Bone & Joint Surgery, 2006
- Registration completeness in the Norwegian Arthroplasty RegisterActa Orthopaedica, 2006
- Undisplaced intracapsular hip fractures: results of internal fixation in 375 patients.2004
- A single European currency for EQ-5D health statesThe European Journal of Health Economics, 2003
- Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: A prospective randomized study of 100 hipsActa Orthopaedica, 2000
- EuroQol: the current state of playHealth Policy, 1996