{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:26:25Z","timestamp":1790821585820,"version":"4.1.0"},"reference-count":24,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T00:00:00Z","timestamp":1483056000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/legalcode"}],"content-domain":{"domain":["openorthopaedicsjournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOORTHJ"],"published-print":{"date-parts":[[2016,12,30]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>The treatment of choice for elderly with a displaced intra-capsular femoral neck fractures is prosthetic replacement. This is however a major surgical procedure for geriatric patients with multiple co-morbidities which can threaten hemodynamic stability and lead to death. In this study we compared the outcome of internal fixation (IF)<jats:italic>versus<\/jats:italic>hemiarthroplasty (HA) for the management of intra-capsular femoral neck fractures in the elderly with severe co-morbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>We conducted a retrospective cohort study of all the patients who were admitted to our Level-II trauma centre with a femoral neck fracture between January 2009 and June 2011. Inclusion criteria were: 70 years or older, ASA 3 or higher, a displaced femoral neck fracture and treatment with either internal fixation or a cemented hemiprosthesis. The primary outcome was 6-month mortality rate. Secondary outcomes were 30-day mortality, post-operative complications, re-operation rate and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>80 patients met our inclusion criteria. The mean age of the IF group was 81.6 years and in the HA group it was 84.5 years (P=0.07). The medical records were retrieved 34-64 months after surgery. Two intra-operative deaths due to cement implantation syndrome were found in the HA group and none in the IF group. Twelve patients (21.8%) in the HA group died within 30 days after surgery and 2 (8.0%) in the IF group (P=0.21). The mean operating time was 83 min. for the HA group and 51 min. for the IF group (P=0.000). There were more implant-related complications in the IF than in the HA group (36%<jats:italic>vs<\/jats:italic>9.1% respectively, P=0.008). The 6-month mortality rates didn\u2019t differ between the IF and the HA groups (respectively 28.0%<jats:italic>vs<\/jats:italic>34.5%, P=0.62).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>The post-operative mortality rates did not differ between the IF and the HA groups in elderly patients with a displaced femoral neck fracture and ASA 3 to 5. However, the HA associated with less implant-related complications than the IF in this group and it is therefore the treatment of choice.<\/jats:p><\/jats:sec>","DOI":"10.2174\/1874325001610010765","type":"journal-article","created":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T04:46:20Z","timestamp":1483591580000},"page":"765-771","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Internal Fixation Versus Hemiarthroplasty for Displaced Intra-Capsular Femoral Neck Fractures in ASA 3-5 Geriatric Patients"],"prefix":"10.2174","volume":"10","author":[{"given":"W.","family":"Rezaie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.I.","family":"Cleffken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.H.","family":"van der Vlies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.I.","family":"Cleffken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.R.","family":"Roukema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.55095\/achot2006\/008","volume":"73","author":"Raaymakers E.L.","year":"2006","unstructured":"Raaymakers EL. 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