[Has femoral neck fracture in older patients to be treated with reposition of fragments and osteosynthesis or with primary aloarthroplasty?]. / Treba li prijelom vrata femura u starijih bolesnika lijeciti repozicijom i osteosintezom ulomaka ili primarnom aloartroplastikom kuka?

ABSTRACT

In this article we analised and compared the efficiency of operative treatment of the femoral neck fracture in two groups of patients, over 70 years of age, treated on different way. The first group were the patients treated by osteosynthesis of the fracture site, and the second group were the patients treated by aloarthroplasty of the hip. All patients had surgery over three days after injury. We found that the group of patients with osteosynthesis had twice bigger unsuccessful results (62.5%) in relation to the group treated with hip aloarthroplasty (31.8%). The relation between the number of reoperations after osteosynthesis and hip aloarthroplasty was 81. We also found that radiological healing ot the fracture site after osteosynthesis happened only in 10% cases. Patients treated with hip aloarthroplasty earlier started to walk without help (1.9 months after surgery) and the patients treated with osteosynthesis could walk five times later (10.59 months after surgery). Although neck femoral fractures in older patients are treated ten times more with hip aloarthroplasty than with osteosynthesis, int his article we showed that hip aloarthroplasty must be the first choice in mostly all patients over 70 years of age. Osteosynthesis has to be used very rare, in patients with lateral neck fractures without dislocations, and it must be done as emergency procedure, not later then 48 hours of injury.