ClinicalThere is a statistically and clinically significant decrease in patients who require reoperations with total hip replacement than with internal fixation. The follow up varied between 1 and 13 years. (LOW QUALITY)

There is a statistically significant, but not clinically significant, increase in patients who reported pain at 1 year with internal fixation compared to total hip replacement (MODERATE QUALITY).

There is no statistically significant difference in mortality at 2 to 4 months, 12 to 18 months or 2 years (LOW QUALITY) and length of hospital stay (MODERATE QUALITY) between internal fixation and total hip replacement.

No RCT evidence was identified reporting functional status, quality of life, total time to resettlement in the community and place of residence after hip fracture.
EconomicTHR is the dominant strategy with respect to internal fixation (less costly and more effective). This evidence has minor limitations and partial applicability.

From: 10, Surgical procedures

Cover of The Management of Hip Fracture in Adults
The Management of Hip Fracture in Adults [Internet].
NICE Clinical Guidelines, No. 124.
National Clinical Guideline Centre (UK).
Copyright © 2011, National Clinical Guideline Centre.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of the National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.