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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Femoral Neck Fractures, Follow-Up Studies, Fracture Fixation, Internal, Humans, Prospective Studies, Radiography, Reoperation, Survival Rate, Treatment Outcome.
user
Is hemiarthroplasty in worst cases better than internal fixation in best cases of displaced femoral neck fractures : a prospective study of 683 patients treated with hemiarthroplasty or internal fixation? Context: Studies have shown that the degree of initial displacement and also comminution of the femoral calcar, size of the head and varus angulation are prognostic of failure in displaced femoral neck fracture. We have applied these radiographic criteria in order to select patients who would benefit from internal fixation as opposed to primary hemiarthroplasty, and this prospective study was conducted in order to monitor the results of this strategy. 683 displaced fractures of the femoral neck were treated with internal fixation or primary hemiarthroplasty based on the proposed radiographic criteria in a prospective consecutive study, and the patients were followed for 1-6 years. We treated 228 fractures with internal fixation and 455 by bipolar hemiprosthesis. The choice of operation was based on clinical evaluation of the patient and assessment of the assumed healing potential of the fracture, as determined by radiographic evaluation. Revision and mortality were primary endpoints. 54 (24%) of the patients originally treated by osteosynthesis were revised, whereas 9 (2%) of the patients treated with hemiarthroplasty had revision surgery. There were no significant differences in mortality between the groups at 30, 120 or 365 days.
assistant
Even when treating only the fractures with the assumed best healing potential with internal fixation, the results are inferior to hemiarthroplasty. Final Decision: yes