JSOA Online

As the elderly population in our society significantly increases, the incidence of displaced femoral neck fractures will increase proportionally. Three surgical procedures are available to treat such fractures: internal fixation, hemiarthroplasty (unipolar or bipolar), and total hip arthroplasty. Long-term costs and efficacy of these three procedures vary, primarily due to postoperative complications. Thus, it is imperative that all surgeons conduct a proper preoperative evaluation of each patient before choosing the optimal treatment plan. Internal fixation has been shown to bemore beneficial for physiologically younger patients who sustain displaced femoral neck fractures. However, the choice between hemiarthroplasty and total hip arthroplasty in the geriatric patient remains difficult. This article aims to provide a practical algorithm for the treatment of these patients. (Journal of Surgical Orthopaedic Advances 19(2):98–103, 2010)