Osteosynthesis and total hip replacement in femoral neck fractures

Three hundred thirty nine patients with femoral neck fractures were operated on during the period from 1990 to 1994. Most of operations were performed within 48-72 hours after trauma. 235 patients with an average age of 70 years were treated by osteosynthesis using plates, srews, rods, DHS. 104 patients with average age of 76 years underwent total hip replacement procedures using Moore, Baitmann, Muller, Spotorno (Etalon, Kiev) implants. 17 patients (5%) died. Out of them 10 patients died after total hip replacement, 4 patients - after closed osteosynthesis and 3 patients - after open osteosynthesis. In 96 patients with osteosynthesis results were evaluated after 1-2 years. Good results were in 78% of them, satisfactory - in 15,7% and bad - in 6,3%. Author supports as early as possible operative treatment of patients with femoral neck fracture and prefers an open osteosynthesis with spongy screws. Advantages of closed osteosynthesis with DHS is noted too.