Single-center RCT enrolling 100 healthy elderly patients (mean age 78, Garden III/IV femoral neck fractures) randomized to THR (n=43) or internal fixation with two cannulated screws (n=57), with follow-up at 3 months and 1, 2, 4, 11, and 17 years. Asks whether the functional and reoperation advantages of THR seen in short-term trials persist over nearly two decades.
For a healthy, cognitively intact patient ≥65 years presenting with a Garden III/IV femoral neck fracture, this trial's 17-year data support primary THR: you halve the overall reoperation risk and eliminate the early catastrophic failures (AVN, nonunion) inherent to fixation, without increasing mortality.
Reserve internal fixation for patients who cannot safely tolerate a longer THR procedure.
Single-center RCT enrolling 100 healthy elderly patients (mean age 78, Garden III/IV femoral neck fractures) randomized to THR (n=43) or internal fixation with two cannulated screws (n=57), with follow-up at 3 months and 1, 2, 4, 11, and 17 years. Asks whether the functional and reoperation advantages of THR seen in short-term trials persist over nearly two decades.
For a healthy, cognitively intact patient ≥65 years presenting with a Garden III/IV femoral neck fracture, this trial's 17-year data support primary THR: you halve the overall reoperation risk and eliminate the early catastrophic failures (AVN, nonunion) inherent to fixation, without increasing mortality.
Reserve internal fixation for patients who cannot safely tolerate a longer THR procedure.