The treatment algorithms for displaced @entity2249 need to be improved if we are to reduce the need for secondary surgery. We have studied 102 @entity1 of mean age 80 years, with an acute displaced @entity174 of the femoral neck. They were randomly placed into two groups, treated either by internal fixation (IF) with two cannulated screws or total hip replacement (THR). None showed severe @entity73 , all were able to walk independently, and all lived in their own home. They were reviewed at four, 12 and 24 months after surgery. Outcome measurements included hip complications, revision surgery, hip function according to Charnley and the health-related quality of life (HRQoL) according to EuroQol (EQ-5D). The failure rate after 24 months was higher in the IF group than in the THR group with @entity532 (36% and 4%, respectively; p < 0.001), and the number of revision procedures (42% and 4%, p < 0.001). Hip function was significantly better in the THR group at all follow-up reviews regarding @entity158 (p < 0.005), movement (p < 0.05 except at 4 months) and walking (p < 0.05). The reduction in HRQoL (EQ-5D index score) was also significantly lower in the THR group than in the IF group, comparing the pre- @entity174 situation with that at all follow-up reviews (p < 0.05). The results of our study strongly suggest that THR provides a better outcome than IF for elderly, relatively healthy, lucid @entity1 with a displaced @entity174 of the femoral neck.

Internal fixation compared with total hip replacement for displaced XXXX in the elderly. A randomised, controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2249 :: ('MESH:D005265', 'Disease') :: ['fractures of the femoral neck'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity73 :: ('MESH:D003072', 'Disease') :: ['cognitive dysfunction'] @entity532 :: ('MESH:D003925', 'Disease') :: ['regard to hip complications'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity2249 :: (MESH:D005265,Disease) :: ['femoral neck fractures']
