Ten Common Problem Fractures--Symposium: The Displaced Femoral Neck

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Fracture: Internal Fixation versus Bipolar Endoprosthesis. Results of a Prospective, Randomized Comparison. Bray, Timothy J. Smith, Hoefer E. Hooper, A. Timmerman, Laura. Clinical Orthopaedics & Related Research. 1988 May. 230. pp 127-140. Copyright 1988 by J. B. Lippincott Company The displaced femoral neck fracture poses difficult decision-making issues for the orthopedic surgeon. Young patients frequently require a rapid open reduction and rigid internal fixation in the face of multiple associated injuries. Elderly patients present the typical decision dilemma of internal fixation versus total arthroplasty. Consecutive, randomized, prospective series of cases for evaluation of alternatives in the treatment of this difficult fracture are lacking. Between 1982 and 1984, 34 elderly patients with displaced femoral neck fractures were randomized to open reduction or hemiarthroplasty study groups. Although the surgical risks are relatively high, two-year observations showed better functional results in the cemented hemiarthroplasty group.