OUTCOMES AFTER DISPLACED FRACTURES OF THE FEMORAL-NECK - A METAANALYSIS OF 106 PUBLISHED REPORTS

Methods of meta-analysis, a technique for the combination of data from multiple sources, were applied to analyze 106 reports of the treatmen t of displaced fractures of the femoral neck. Two years or less after primary internal fixation of a displaced fracture of the femoral neck, a non-union had developed in 33 per cent of the patients and avascula r necrosis, in 16 per cent. The rate of performance of a second operat ion within two years ranged from 20 to 36 per cent after internal fixa tion and from 6 to 18 per cent after hemiarthroplasty (relative risk, 2.6; 95 per cent confidence interval, 1.4 to 4.6). Conversion to an ar throplasty was the most common reoperation after internal fixation and accounted for about two-thirds of these procedures. The remaining one -third of the reoperations were for removal of the implant or revision of the internal fixation. For the patients who had had a hemiarthropl asty, the most common reoperations were conversion to a total hip repl acement, removal or revision of the prosthesis, and debridement of the wound.