Classification and surgical approaches to hip fractures for nonsurgeons

The location and type of hip fracture, and the patient's activity level, help to determine the method of surgical repair. Nondisplaced femoral neck fractures are treated with screw fixation. Displaced fractures are treated with arthroplasty. If the patient is very active, the treatment of choice should be total hip replacement, whereas if the patient is less active, the treatment of choice is hemiarthroplasty. Intertrochanteric fractures are classified as stable (treated with a sliding hip screw) or unstable (treated with an intramedullary hip screw). Subtrochanteric fractures are classified as typical or atypical. All subtrochanteric fractures are treated with intramedullary hip screws.