[Femoral neck fractures after age 65: morbidity, mortality, lethality]

In 1984, in France, 7,916 deaths of persons over 65 yr were due to femoral neck fracture (national statistics of mortality). In the same age group, the annual number of surgical procedures performed for this reason was estimated from a national survey to be 36,300 in 1980. The proportion of deaths and surgical procedures due to this condition increases with age and is always higher in females. The same result is observed concerning the annual incidence of deaths and the incidence of operations (2 p. 1000 in males, 6 p. 1000 in females over 65 yr). Lethality was assessed by relating figures of mortality and surgical morbidity (1 death p. 4.6 operations). It was higher in males (1 death p. 3.5) than in females (1 death p. 4.9). The difference between males and females was more marked in younger age groups (ratio of 3 in the 65-69 yr group) and decreased with age. This excess-lethality in males is partly due to a poorer preoperative condition, and especially to a greater frequency of coexisting respiratory failure.