This systematic review and meta-analysis (4 studies, 579 patients) compares hemiarthroplasty versus internal fixation for nondisplaced and minimally displaced (Garden I/II) femoral neck fractures in patients ≥60 years old, with reoperation as the primary outcome.
When an elderly patient (especially in their late 70s–80s) presents with a nondisplaced femoral neck fracture, don't reflexively default to cannulated screws — this meta-analysis shows a 70% relative reduction in reoperation risk with primary hemiarthroplasty, and failed fixation requiring secondary arthroplasty carries worse outcomes than going primary.
Weigh this against the real perioperative costs of arthroplasty: longer surgery, more blood loss, higher transfusion rates, and longer hospitalization.
This systematic review and meta-analysis (4 studies, 579 patients) compares hemiarthroplasty versus internal fixation for nondisplaced and minimally displaced (Garden I/II) femoral neck fractures in patients ≥60 years old, with reoperation as the primary outcome.
When an elderly patient (especially in their late 70s–80s) presents with a nondisplaced femoral neck fracture, don't reflexively default to cannulated screws — this meta-analysis shows a 70% relative reduction in reoperation risk with primary hemiarthroplasty, and failed fixation requiring secondary arthroplasty carries worse outcomes than going primary.
Weigh this against the real perioperative costs of arthroplasty: longer surgery, more blood loss, higher transfusion rates, and longer hospitalization.