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Fractures of the neck of the femur

Department of Orthopaedic Surgery, Peterborough District Hospital, Peterborough, PE3 6DA England, mjparker{at}doctors.org.uk

A hip fracture represents one of the commonest reasons for an elderly patient to be admitted to an acute orthopaedic ward. The average age of patients is about 80 years and the most patients are female. Surgical treatment is recommended for the majority of fractures. For intracapsular fractures internal fixation is indicated for all undisplaced fractures and displaced fractures in those aged less than about 65—70 years. Arthroplasty is more appropriate for the elderly patient with a displaced intracapsular fracture. A cemented unipolar hemiarthroplasty is generally used, but for the fitter active patients a total hip replacement may be superior. The sliding hip screw remains the implant of choice for trochanteric hip fractures with intramedullary fixation being mainly used for subtrochanteric fractures. Aggressive rehabilitation methods with minimally transfer of patients and early community support programmes can reduce the length of hospital stay.

Key Words: hip fracture • proximal femur fracture

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