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Updated: Jun 3, 2026

Imaging of the Microstructural Failure Mechanism in the Human Hip

Imaging of the Microstructural Failure Mechanism in the Human Hip

Published on: September 29, 2023

Fractures in the elderly: when is hip replacement a necessity?

Prasad Antapur¹, Nizar Mahomed, Rajiv Gandhi

¹Toronto Western Hospital, Toronto, Ontario, Canada.

Clinical Interventions in Aging

|April 8, 2011

Summary

Hip fractures in the elderly are a major health issue, increasing mortality and economic burden. This review explores primary total hip replacement as a treatment for femoral neck fractures, showing better functional outcomes.

Keywords:

elderly hip fractures hip replacement

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Area of Science:

Orthopedic surgery
Geriatric medicine
Trauma care

Background:

Hip fractures are a significant health problem in the aging global population.
Elderly hip fractures lead to reduced mobility, increased morbidity, and mortality (14-36% one-year mortality).
Associated conditions like osteoporosis, comorbidities, and dementia complicate treatment decisions and outcomes.

Purpose of the Study:

To review current literature on hip fracture management.
To identify indications for primary total hip replacement in elderly patients with femoral neck fractures.
To evaluate functional outcomes of different treatment modalities.

Main Methods:

Literature review of current research on hip fracture treatment.
Analysis of studies comparing primary total hip replacement with other interventions.
Examination of fracture types: extracapsular (pertrochanteric) vs. intracapsular (femoral neck).

Main Results:

Pertrochanteric fractures are managed effectively with internal fixation (sliding hip screw or intramedullary devices).
Intracapsular femoral neck fractures carry risks of nonunion and osteonecrosis.
Emerging evidence suggests better functional outcomes with primary total hip replacement for femoral neck fractures.

Conclusions:

Primary total hip replacement may offer superior functional outcomes for specific hip fracture types in the elderly.
Further research is needed to solidify indications and long-term benefits.
Optimizing treatment for elderly hip fractures is crucial due to high mortality and economic impact.