A further comparison of the use of internal fixation and prosthetic replacement for fresh fractures of the neck of the femur

Abstract

Two hundred patients with femoral neck fractures have been reviewed. One hundred were treated by a primary prosthesis and the remainder by internal fixation. The complications and results of the two groups are compared and discussed. These results are compared with a similar survey carried out in Oxford 5 years ago. The mortality rate in the group treated by prosthetic replacement is higher than in the group treated by internal fixation. This survey again indicates that internal fixation offers the patient with a displaced fracture of the neck of the femur a lower morbidity and mortality rate and better results than the insertion of a prosthesis. The use of a primary prosthesis should be confined to patients in whom accurate reduction of the fracture is impossible or in pathological fractures where maintenance of the reduction is unlikely.