Acta Chir Belg
-
From 1987 to 1996, 778 unstable fractures of the femoral neck Garden type III or IV in 736 patients over 70 years of age have been treated surgically. Based on age and functional preinjury status, 477 patients were treated with a hemiarthroplasty; a total hip prosthesis was implanted in another 301 patients. The overall mortality rate at one year was 20%. ⋯ Despite good functional results observed after total hip arthroplasty for fractures, we recommend this technique only in selected cases. The risk for prosthetic loosening is also much higher after replacement for fracture than after replacement for osteoarthritis (at least 14% within 5 years). Nevertheless, we prefer a total prosthesis implant in patients with a good life expectancy and good functional condition, aged between 70 and 80 years, presenting a severely displaced unstable fracture.