Abstract / Summary
Femoral neck fractures in elderly patients remain one of the most serious problems of emergency traumatology because of high mortality, frequent reoperations and loss of independence. This paper analyses the results of surgical treatment of femoral neck fractures in patients aged 50 years and older on the basis of a meta-analysis of 106 published reports and four international randomised controlled trials with a total of 6,798 patients. Internal fixation of displaced fractures is associated with non-union in 33% and reoperation in 20–36% of patients, whereas arthroplasty reduces the reoperation rate to 6–18%. Total hip arthroplasty and hemiarthroplasty give similar reoperation rates (7.9% vs 8.3%); cemented hemiarthroplasty provides better quality of life and fewer periprosthetic fractures than uncemented fixation. Accelerated surgery within 6 hours did not reduce 90-day mortality compared with standard care.