Related Experiment Video
Updated: May 13, 2026
Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture
Published on: March 3, 2023
Internal fixation versus cemented hemiarthroplasty for displaced femoral neck fractures in patients with severe
Carl-Johan Hedbeck1, Christian Inngul, Richard Blomfeldt
1*Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden; and †Karolinska Institutet, Department of Clinical Science and Education, Orthopaedic Unit, Stockholm South Hospital/Södersjukhuset, Stockholm, Sweden.
Objectives:
To compare the outcome of internal fixation (IF) versus a cemented hemiarthroplasty (HA) in patients with a displaced femoral neck fracture and a severe cognitive dysfunction.
Design:
A prospective randomized controlled trial.
Setting:
A tertiary care university hospital.
Patients:
Sixty patients with a displaced femoral neck fracture were randomized to IF (n = 30) or HA (n = 30). All patients suffered from severe cognitive dysfunction but were able to walk before the fracture.
Intervention:
IF using 2 cannulated screws or HA using a cemented Exeter unipolar arthroplasty.
Main Outcome Measurements:
Patients were reviewed at 4, 12, and 24 months after the fracture. Outcome assessments included complications, reoperations, hip function (Charnley score), and health-related quality of life (EQ-5Dindex score).
Results:
A total of 8 patients were reoperated (14%); 7 in the IF group and 1 in the HA group. The EQ-5Dindex score at the follow-ups were generally lower in the IF group compared with the HA group with a significant difference at 12 months (P = 0.03). No difference was seen in hip function, general complications, or mortality between the groups.
Conclusions:
HA seems to provide a safe option with better health-related quality of life and less risk for reoperations compared with IF for these patients.
Level Of Evidence:
Therapeutic level II.
