Primary prosthetic replacement for femoral neck fractures.

Treatment of displaced femoral neck fractures remains a problem. Routine prosthetic replacement is controversial. Review of 100 patients treated at the Campbell Clinic from 1957 to 1966 suggests that 60% long-term good results can be anticipated at a cost of 5% mortality and 25% morbidity. We believe prosthetic replacement probably should be restricted to (1) those patients admitted for treatment late or those in whom previous internal fixation has failed, (2) elderly patients whose fracture cannot be reduced closed, and (3) patients with special circumstances such as pathologic fractures, seizure disorders, Parkinsonism, and so on.