Primary total hip replacement in patients with displaced femoral neck fractures

Purpose of review The present review describes the surgical management of displaced femoral neck fractures with total hip replacement as a means to reduce postoperative complications, cost, and postfracture morbidity. Recent findings Multiple studies now indicate that, when performed optimally, total hip arthroplasty provides the most functional outcome for elderly patients after displaced femoral neck fractures. Although not all elderly patients with displaced femoral neck fractures are candidates for total hip arthroplasty, active, mentally competent, independent patients achieve the most predictable, durable and cost-effective results with total hip arthroplasty. Summary The optimal surgical management choice for the treatment of displaced femoral neck fractures in the elderly is controversial. The goal of surgical treatment is the relief of pain and the restoration of prefracture function. Total hip replacement offers elderly patients with displaced femoral neck fractures the best opportunity for return to an independent lifestyle and a prefracture level of activity, while minimizing the risk and cost of postoperative complications.