Femoral neck fractures: a changing paradigm

Area of Science:

• Orthopedic surgery
• Traumatology

Background:

• Hip fractures necessitate surgical intervention, traditionally internal fixation (IF) or total hip replacement (THR).
• Treatment decisions historically relied on fracture displacement, but patient factors are increasingly considered.
• Total hip replacement (THR) shows superior functional outcomes for displaced femoral neck fractures compared to IF, though dislocation risk is a concern.

Purpose of the Study:

• To propose a treatment algorithm for femoral neck fractures.
• To guide surgical decisions by integrating fracture characteristics and patient factors.
• To optimize patient mobility and functional outcomes after hip fracture repair.

Main Methods:

• Review of current literature on hip fracture treatment options (IF vs. THR).
• Analysis of factors influencing surgical decision-making, including fracture displacement and hip joint arthritis.
• Development of a treatment algorithm based on clinical evidence and patient characteristics.

Main Results:

• Internal fixation (IF) is recommended for minimally displaced fractures without arthritis.
• Total hip replacement (THR) is preferred for displaced fractures or those with pre-existing arthritis.
• Emerging technologies and surgical techniques aim to mitigate THR dislocation risks.

Conclusions:

• A tailored approach to femoral neck fracture treatment is essential.
• The proposed algorithm aids in selecting between IF and THR for improved patient outcomes.
• Integrating fracture severity and joint condition optimizes surgical intervention selection.