Hip fractures and Parkinson's disease. A clinical review of 94 fractures treated surgically.

A series of 87 parkinsonian patients with 94 hip fractures were reviewed to reexamine the evidence for internal fixation versus hemiarthroplasty. Forty-seven subcapital Garden Type I and Type II fractures and transcervical fractures were treated by nailing, and 47 Garden Type III and Type IV fractures were treated by hemiarthroplasty. There were twice as many complications in the hemiarthroplasty group as in patients treated by nailing, including four wound infections and five dislocations, all with uniformly bad results. Patients treated by nailing regained greater ambulatory independence than those with a hemiarthroplasty. The parkinsonian patients with hip fractures treated by internal fixation had better results than those treated by hemiarthroplasty; hemiarthroplasty may be even contraindicated.