This RCT randomized 455 patients aged over 70 with displaced intracapsular hip fractures to hemiarthroplasty or internal fixation, comparing operative parameters, reoperation rates, mortality, and functional outcomes over up to 3 years of follow-up.
For most patients over 70 with a displaced femoral neck fracture, choose hemiarthroplasty — the operative advantages of internal fixation are outweighed by a 40% reoperation rate.
Reserve internal fixation for the very frail patient in whom the additional surgical stress of arthroplasty poses unacceptable short-term risk, accepting that reoperation may be needed.
This RCT randomized 455 patients aged over 70 with displaced intracapsular hip fractures to hemiarthroplasty or internal fixation, comparing operative parameters, reoperation rates, mortality, and functional outcomes over up to 3 years of follow-up.
For most patients over 70 with a displaced femoral neck fracture, choose hemiarthroplasty — the operative advantages of internal fixation are outweighed by a 40% reoperation rate.
Reserve internal fixation for the very frail patient in whom the additional surgical stress of arthroplasty poses unacceptable short-term risk, accepting that reoperation may be needed.