Geriatric Orthopaedics

Abstract

Fractures of the femoral neck present a threat to the mobility and independence of geriatric patients. Multiple treatment options exist for femoral neck fractures, each with its inherent advantages and disadvantages. Internal fixation produces good results if the complications of nonunion, avascular necrosis and shortening can be avoided. Unfortunately, these complications remain prevalent in many circumstances leading many to proceed with femoral head replacement. Complicating decision-making are the multiple variations of replacements that are available. These include cemented or uncemented femoral stems, unipolar or bipolar head components and the option of placing an acetabular component. Many factors are relevant to decision-making with this injury. These include patient age, activity, co-morbidities and functional demands. These must be considered alongside fracture variables that include displacement, comminution and bone quality. This review will sequentially consider the available treatment options and attempt to distill the existing literature into practical treatment guidelines.