Displaced Femoral Neck Fracture in Elderly Patients: Comparison of Primary Total Hip Arthroplasty with Internal Fixation

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Clinical Resident, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 3 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: The Best treatment for displaced intracapsular fracture of the femoral neck in active and lucid elderly patients is still controversial. The main aim of our study was to determine whether a primary total hip arthroplasty (THA) or internal fixation (IF) give a better outcome. Methods: In this randomized clinical-trial study, among patients referred to Isfahan University of Medical Sciences Hospitals in Isfahan, Iran, 80 patients in the ages of 60-70 years old with displaced intracapsular fracture of the femoral neck ware enrolled. Studied patients were randomly assigned into two groups. Internal fixation was the only therapeutic method in first group; and total hip arthroplasty was done in the second group. Then, patients were evaluated. The severity of pain, hip function (Harris Hip Score) and health related quality of life were assessed one year after the procedure. Findings: The severity of pain, the rate of complication, and need to reoperation were significantly lower in patients treated with THA. Quality of life and hip function were significantly better in these patients, too. Conclusion: It seems that THA is a more effective method in treatment of the femoral neck fracture in elderly patients. Key words: Femoral neck fracture, Total hip arthroplasty, Internal fixation.