The Outcome of Undisplaced Femoral Neck Fracture in Elderly

Abstract

The management of Garden type 1 and 2 undisplaced proximal femoral intracapsular fracture in elderly patients is controversial. Many options including arthroplasty and fixation have been suggested based on patient's age and cognitive function. We have retrospectively reviewed 85 elderly patients with undisplaced femoral neck fracture. The mean age of the cohort was 81 years. 52 patients were treated with cemented hemi-arthroplasty, 19 with dynamic hip screw fixation, 10 had cannulated screw fixation, total hip replacement in 3, and conservative management for one patient. We reviewed the cohort for a mean period of 3 years and we looked into their general complications, local complications related to the hip and mortality. and 32% with Dynamic Hip screw), had good outcome. All the patients treated using total hip replacement, the patient treated conservatively, also had good outcome and 56% of the fixation group had poor outcome. The good results of hemiarthroplasty were predictable for patients with ASA III (27), and ASA IV (11). Patients chosen to have THR had better ASA grade than the remaining. In general the outcome in arthroplasty group was superior to the DHS and cannulated screws. Conclusion: From the study it is clearly evident that arthroplasty provides better outcome for elderly patients with undispalced femoral neck fracture especially with poor cognitive function.