These fractures occur in the head and neck of the femur within the joint capsule, the lubricating fluid surrounding the joint. Typically, patients will undergo hip arthroplasty or internal fixation of the fracture. Hip arthroplasty is a hip replacement. Internal fixation for this fracture pattern usually consists of screws.
If the fracture is displaced, unstable, or due to osteoporosis, the surgeon may recommend a hip replacement. Older patients who underwent hip arthroplasty after hip fractures reported better index scores, greater satisfaction, and less pain than their counterparts who underwent internal fixation. Additionally, only 11% of people treated with hip replacements in one study needed repeat surgery compared to 40% of those with internal fixation in one study.
Hip replacements are also beneficial for younger, fit patients who will need a treatment that supports a higher level of activity for a longer duration. However, there is also data that suggests that people who undergo hip replacements for hip fractures have a greater risk of hip displacement. This displacement could cause a fall, which is especially concerning for frail or elderly patients. Hip fractures and falls are a major risk factor for increased mortality in older patients.