Orthopedic treatment of hip fracture.

There are those who advocate nonoperative treatment of impacted femoral neck fractures, but in general there is consensus that surgery is the treatment of choice for both trochanteric hip fracture and femoral neck fracture. As for trochanteric fractures, modern results after internal fixation are characterized by only a low percentage of secondary operations, even for unstable fractures and when full weight bearing is permitted immediately after operation. The high rates of complication after internal fixation of femoral neck fractures and the insignificant improvement of these results over the decades have made prosthetic replacement an alternative method of treatment, at least for dislocated femoral neck fractures. Until a quantifiable prognostic method to judge whether a given femoral neck fracture will heal is available, and until sufficiently large, prospective techniques have been undertaken, diverging opinions about the operative treatment of choice will persist.