Treatment of hip fractures in elderly and senile patients.

Hip fractures in elderly and senile patients are associated with a high incidence of morbidity and mortality. For this reason, restoration of function rather than restoration of the hip must be the first concern. In senile patients with intertrochanteric fractures, condylocephalic fixations is preferred because of the decreased infection rate. In patients with severe osteoporosis, bed rest with traction as needed for comfort may be preferable. Fractures of the femoral neck in this group are best treated with percutaneous pin fixation. In the elderly ambulatory patient with no more than minimal confusion, compression screw fixation with severe osteoporosis in these patients should have adjunctive use of methylmethacrylate. In this group, fractures of the femoral neck in our experience are better treated with a cemented endoprosthesis or total hip arthroplasty.