Abstract
In a prospective randomised trial, 455 patients presenting to one hospital with a
displaced intracapsular fracture were randomised to either closed reduction and internal
fixation with three cancellous screws or replacement with an uncemented hemiarthroplasty.
Follow-up of surviving patients was for between 9 and 15 years to determine the long-term
outcome for the two treatment methods. 93% of patients died during this follow-up
period. There was no difference in mortality between the two procedures. The need
for revision surgery to the hip was increased for those treated by internal fixation
(93% versus 62% implant survival rate; hazard ratio: 0.14, 95% CI 0.08–0.24). 91%
of revision's operations occurred within 2 years from injury. There was no difference
in the degree of residual pain between groups neither was there any difference in
the number of patients requiring institutional care. These results demonstrate that
both treatment methods produce comparable final outcomes but internal fixation is
associated with an increased re-operation rate.
Keywords
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References
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Article info
Publication history
Accepted:
October 2,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
