Primary total hip replacement for displaced subcapital femoral fractures

It is widely accepted that anatomic reduction and fixation is the most effective treatment for femoral subcapital fractures when there are no late complications. Displaced fractures in the elderly are commonly treated by hemi-arthroplasty, but in some cases, especially in active patients, acetabular erosion or loosening of the prosthesis may occur several years after the operation. Between 1972-1983, 15 relatively active, healthy patients with displaced subcapital fractures were treated by primary total hip arthroplasty and all were recently examined. The average age at operation was 67 years (range 49-78) and the duration of follow-up since operation ranged from 0.9-12 years (av 3.7). Most had satisfactory results with regard to pain, physical activity and firmness of the prosthesis and none had dislocation of the prosthesis. These results suggest that this procedure should be used more often in biologically young patients.