Internal fixation versus hemiarthroplasty for displaced fractures of the femoral neck in elderly patients with severe cognitive impairment

Sixty patients with an acute displaced fracture of the femoral neck were randomized to receive internal fixation (IF) with cannulated screws or hemiarthroplasty (HA) using an uncemented Austin Moore prosthesis. At final follow-up, the HA group had significantly lower health related quality of life scores than the internal fixation group. There was a trend toward a higher re-operation rate in the IF group than the HA Group, although the difference was not statistically significant. Also, the HA group had decreased mobility compared to the internal fixation group, but these differences were not significant. The two groups also did not differ when it came to complications, mortality, status of activities of daily living, and hip function.