Mobility and functional outcomes after femoral neck fracture surgery in elderly patients: a comparison between hemiarthroplasty and internal fixation

PURPOSE: To find out whether patients with femoral neck fracture treated with hemiarthroplasty differ from those treated with internal fixation regarding functional outcome, walking ability, pain or short-term mortality. METHOD: Sixty-six patients aged 64 years or more with femoral neck fracture were included in a prospective non-randomised trial with two equal-sized groups recruited consecutively within each group. All patients were treated operatively and encouraged to pursue an active rehabilitation. They were reviewed at admission, before discharge and 3 months after surgery. Assessments included demographic data, length of hospitalisation, post-operative medical complications, activities of daily living, walking ability, pain and mortality. RESULTS: There were no significant differences between the two groups in terms of age, gender, ability to walk, functional status or at admission. The patients treated with hemiarthroplasty had a longer total hospital stay due to longer waiting time to operation. They started to walk sooner after operation and walked better during hospitalisation. Their walking distance at discharge was longer; their improvement in functional independence, as measured by the Functional Independence Measure, was also higher, but this difference was not statistically significant. Observed mortality in the hemiarthroplasty group was lower. CONCLUSION: A longer follow-up would be necessary to determine whether the preferable outcomes of hemiarthroplasty persist in the long-term.