[Treatment of femoral neck fractures with endoprostheses in the aged].

A primary prosthetic replacement is advocated for all elderly patients with displaced fractures of the femoral neck. The aim of the study was to determine the effectiveness of this method of treatment. Patients admitted to the Department of Orthopedics, University Hospital Firule, Split, from 1977 through 1989 were analyzed. Over this period, a total of 350 hip joint endoprostheses were implanted (233 hemiarthroplasties, 38 total hip arthroplasties and 79 biarticular endoprostheses). Postoperative complications occurred in 10.85% of cases [infections (1.43%), luxations of endoprostheses (4.28%), loosening of the femoral component (2%), intrahospital mortality (1.43%), perforations of the femur (0.86%), lesions of the sciatic nerve (0.57%) and fractures of the endoprosthetic stem (0.28%)]. Fifty patients were followed. Using the clinical and radiologic criteria, functional results were evaluated. Excellent results were reported in thirty-seven (74%), good results in eight (16%), and poor results in five patients (10%). All arthroplasties carry a certain risk which could be diminished by the improvement of both fundamental characteristics of endoprostheses and surgical techniques. In summary, we feel this is the best method to be utilized in elderly patients with the femoral neck fractures.