Endoprosthesis in medial femoral neck fractures

Alloarthroplasty of the hip joint in the elderly has improved significantly the outcome of femoral neck fractures. The indication for a hip replacemen t is based on the biological age of the patient and the type of fracture. I n our hospital in a 5-years period (1996-2000) we treated operatively 305 p atients with femoral neck fractures (248 medial., 57 lateral). Of these, 23 9 patients received a endoprosthesis (190 total hip joint replacements, 49 hemialloarthroplasty). The other 66 patients (most of them younger patients ) were treated by osteosynthesis. The complication rate of the endoprosthet ic hip replacement was low; five hematoma/seroma and two deep infections ha d to be treated operatively. In 21 patients (8.79%) we saw hip luxation; 17 could be treated by closed and four by open reduction. Reluxation was foun d in nine of these 21 patients. Only two patients (both over 80 years old) died between the first 2 postoperative weeks. Eighty percent of the patient s were able to walk, half of them alone or with help outside their homes. F ifteen percent of the patients could be mobilized in a wheel chair; only 5% were confined to bed. Conclusion: For the treatment of femoral neck fractu res in older patients, the cemented hip endoprosthesis is the method of cho ice.