• Jussi Kosola, Antti Kaipia, Minna K Laitinen, and Jyrki Nieminen.
• Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.
• Arch Orthop Trauma Surg. 2017 Jul 1; 137 (7): 967-973.

PurposeOne-third of hip fractures occur in men. The causes underlying hip fractures in men differ from those in women and include alcohol abuse. This retrospective register study evaluated the trends and results associated with different surgical treatment methods for nondisplaced and displaced femoral neck fractures in male patients with alcohol dependence syndrome.MethodsMen with hip fractures were identified from a local district hospital database. Alcohol dependence syndrome was identified as a diagnosis in medical records.ResultsFor displaced fractures, implant survival after total hip arthroplasty was significantly lower compared to hemiarthroplasty. For nondisplaced fractures, implant survival of cannulated screws was significantly lower compared to sliding hip screws. Overall patient survival for males with alcohol dependence syndrome with hip fracture was 62% at 1 year and 49% at 2 years. Patient survival in this population did not differ between displaced and nondisplaced fractures or among different surgical methods.ConclusionPatients with alcoholism who had documented evidence of alcohol dependence syndrome represented nearly half of patients <70 years old with low-energy hip fracture. In patients with nondisplaced femoral neck fractures, stability of the internal fixation appeared to play a major role in implant survival; sliding hip screws should be considered over multiple cannulated screws. In patients with displaced fracture, total hip arthroplasty was associated with a significantly higher risk of complications leading to revision compared to hemiarthoplasty.Level Of EvidencePrognostic Level III.

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