What is a compact fracture

Cochrane

Fractures of the thigh bone within the joint capsule (so-called intracapsular fractures) can be treated by fixation with nails or screws or by replacing the upper end of the thigh bone (femoral head) with an artificial hip joint.

Nineteen studies with 3,044 participants, including two new studies, were included in this updated review. Some studies had weak methods that required a more careful interpretation. In the included studies, there were many different types of materials and methods used for both types of treatment.

It found that each type of treatment had specific complications. Bone re-establishment and internal fixation of the fracture is a shorter operation with less blood loss. However, the need for a second operation after internal fixation is greater than with joint replacement due to insufficient bone healing (40% compared with 11%). With regard to the death rate (at different points in time of the follow-up), no clear differences were found between the treatment groups. People with an artificial hip joint that was fixed with cement appeared to have less residual pain and better joint function than those whose fracture was treated with fixation. There isn't enough evidence to say with certainty whether restraint or joint replacement is the better treatment for a femoral neck fracture.