![]() Since then, this type of prosthesis has gained popularity for the treatment of displaced femoral neck fractures because of its ease to implant in a short period of time. Single component devices are based on models pioneered by Moore and Thompson in the 1950's. It aims to distil from the literature the best available treatment for this important patient population. The present review focuses on the treatment of femoral neck fractures in patients of 60 years and older to discuss indications, techniques, limitations and problems of each of these techniques. Therefore, surgeons cannot be sure, whether they offer the best care available to their patients. Hence, the optimal treatment of this patient population is still under debate. In contrast, reconstruction options include: hemiarthroplasty (HA) - unipolar and bipolar - and total hip arthroplasty (THA). Worldwide, some surgeons treat older patients similar to younger ones by CRIF using cannulated screws or devices like the sliding hip screw. ![]() Often, the type of implant is dictated by the surgeons training. general surgeons provide care in musculoskeletal trauma, while this care is provided by orthopaedic trauma surgeons elsewhere. This is merely based on personal believes determining the management of patients than evidence from the literature. While in younger patients (20-50 years), closed reduction and internal fixation (CRIF) is routinely performed, the treatment of older patients with intracapsular femoral neck fractures largely depends on local conditions, patient profiles, personal preferences and training of the surgeon. Therefore, the appropriate treatment of femoral neck fractures is mandatory. Especially in the elderly, femoral neck fractures represent a significant health care problem and have enormous impact on health insurance costs. Paralleling trends of demographic forecasts, their incidence will continue to rise in the future. HA should only be implanted in patients with limited life expectancy.įemoral neck fractures are frequent injuries in the patient population of every trauma center and have a high incidence in the general population. THA is the treatment of choice for femoral neck fractures in patients older than 60 years. Therefore, it can only be recommended as a second line of defense-procedure for patients with low functional demands and limited live expectancy. Based on our findings, bipolar hemiarthroplasty, similar to unipolar hemiarthroplasty, cannot restorate neither anatomical nor biomechanical features of the hip joint. THA is beneficially implanted using an anterior approach exploiting the internervous plane between the tensor fasciae latae and the sartorius muscles allowing for immediate full weight-bearing. THA yields the best functional results in patients with displaced femoral neck fractures with complication rates comparable to HA. The resulting articles were then reviewed with regard to the different techniques, outcome and complications of the distinct reconstruction options. In addition, cross-referencing was used to cover articles eventually undetected by the respective search strategies. The Pubmed database was searched for all articles on femoral neck fracture and for the reconstruction options presented in this review using the search terms "femoral neck fracture", "unipolar hemiarthroplasty", "bipolar hemiarthroplasty", and "total hip arthroplasty". The purpose of this review is to discuss the indications, limitations, and pitfalls of each of these techniques. Reconstruction options using hip arthroplasty include unipolar or bipolar hemiarthroplasty (HA), and total hip arthroplasty (THA). Femoral neck fractures in the elderly are frequent, represent a great health care problem, and have a significant impact on health insurance costs.
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