A survey of the treatment of displaced intracapsular femoral neck fractures in the UK

A survey was undertaken to investigate the treatment of displaced intracapsular femoral neck fractures across the UK. The usual practice at 223 hospitals was recorded for two groups of patients. active and frail. Management of stereotyped fractures, in similar patients, varied between hospitals. There was also variation between specialists within sonic hospitals: two or more of the alternative methods of treatment were in routine use for active patients at 22% of hospitals and for frail patients at 27%. Overall, for active patients, bipolar hemiarthroplasty was undertaken at 41% of hospitals, internal fixation at 37%, unipolar hemiarthroplasty at 3210 and total hip replacement at 16%. Cemented prostheses were used in 74% of arthroplasties for active patient,. For frail patients, hemiarthroplasty with an Austin Moore or Thompson prostheses was undertaken at 941 of hospitals: bipolar prostheses were used at 810: internal fixation was undertaken at 1%. Cement was used in 46% of hemiarthroplasties. These findings indicate a lack of consensus in aspects of the treatment of displaced intracapsular femoral neck fractures and are likely to reflect difficulties in determining "best practice." (C) 2002 Elsevier Science Ltd. All rights reserved.