Why the study?
Hemiarthroplasty yields lower reoperation frequency and better mobilization than internal fixation in undisplaced femoral neck fractures, which might translate into lower mortality.
Does arthroplasty for displaced femoral neck fracture compared with internal fixation for undisplaced fracture affect mortality and reoperation risk in patients older than 70 years?
Population
19,260 FNF treated with arthroplasty and 10,337 FNF with IF in patients older than 70 years
Comparison
Undisplaced FNF treated with IF vs displaced FNF treated with arthroplasty
Design
Population-based cohort study
Follow-up
Up to 5 years
Key result
Arthroplasty for displaced femoral neck fractures was associated with a higher risk of 30-day mortality compared with internal fixation for undisplaced fractures (HR 1.3; 95% CI 1.3-1.4).
Authors
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Higher 30-day mortality with arthroplasty for displaced FNF warrants caution; leaves open whether selection bias explains findings in registry data.
Cohort (n=29,597)
Yes
Does arthroplasty for displaced femoral neck fracture compared with internal fixation for undisplaced fracture affect mortality and reoperation risk in patients older than 70 years?
Hazard Ratio: 1.3 (95% CI 1.3–1.4)
In patients over 70 with femoral neck fractures, arthroplasty for displaced fractures is associated with higher 30-day mortality but lower long-term reoperation rates compared to internal fixation for undisplaced fractures.
Viberg et al. (2020) conducted a cohort in Femoral neck fractures (n=29,597). Arthroplasty for displaced femoral neck fractures vs. Internal fixation for undisplaced femoral neck fractures was evaluated on 30-day mortality (HR 1.3, 95% CI 1.3-1.4). Arthroplasty for displaced femoral neck fractures was associated with a higher risk of 30-day mortality compared with internal fixation for undisplaced fractures (HR 1.3; 95% CI 1.3-1.4).