Displaced Femoral Neck Fracture in Elderly Patients: Comparison of Primary Total Hip Replacement with Internal Fixation

Treatment of displaced femoral neck fracture in active elderly people is a major undertaking with still unsolved issues. The aim of this study is to determine if primary total hip arthroplasty would have as good an outcome as primary internal fixation of the fracture. In a clinical trial study 80 cases of displaced femoral neck fracture who referred to the university hospitals of Isfahan Iran were enrolled into two treatment groups. Group I of 40 patients received screw fixation and the group II of remaining 40 underwent primary hip arthroplasty surgery. In a 2 year follow-up the surgical outcomes were assessed using VAS pain scale SF36 general health instrument score and Harris hip score (HHS). The pain scale (VAS) SF36 and Harris scores showed significantly better results is arthroplasty group compared with fixation group. The values were as follows: Group 1: pain=4.5 (from 10) SF36=68 HHS=61; group II: pain=3.38 SF36=92 HHS=86. Complications were encountered in 16 cases (40%) in group I and 3 cases (7%) in group II. Displaced femoral neck fractures in 60-70 years old patients treated with primary total hip arthroplasty will have better outcomes in first 2 years with less complication rates.