Table 10-33Internal fixation vs hemiarthroplasty - Clinical summary of findings

OutcomeInterventionControlRelative riskAbsolute effectQuality
Mortality at 1 month7/112 (6.3%)10/110 (9.1%)RR 0.69 (0.27 to 1.74)28 fewer per 1,000 (from 66 fewer to 67 more)Low
Mortality at 3 to 6 months107/765 (14%)122/709 (16.7%)RR 0.81 (0.64 to 1.03)32 fewer per 1,000 (from 60 fewer to 5 more)Low
Mortality at 1 year148/636 (23.3%)143/584 (23.6%)RR 0.93 (0.78 to 1.12)17 fewer per 1,000 (from 52 fewer to 28 more)Moderate
Mortality at 2 to 3 years265/750 (35.3%)254/683 (37.8%)RR 0.96 (0.84 to 1.09)15 fewer per 1,000 (from 60 fewer to 34 more)Moderate
Total no. of reoperations (follow-up 1 to 5 years)355/1001 (35.5%)99/1033 (9.4%)RR 3.59 (2.93 to 4.39)243 more per 1,000 (from 181 more to 319 more)Low
Failure to return to same residence (follow-up 1 to 3 years)29/187 (15.5%)34/185 (23.6%)RR 0.84 (0.54 to 1.33)38 fewer per 1,000 (from 109 fewer to 78 more)Low
Failure to regain mobility (follow-up 1 to 5 years)155/287 (54%)165/306 (45.7%)RR 1.02 (0.74 to 1.39)9 more per 1,000 (from 119 fewer to 178 more)Very low
No. of patients reporting pain at 1 year126/280 (45%)127/281 (44.2%)RR 0.97 (0.66 to 1.44)13 fewer per 1,000 (from 150 fewer to 194 more)Very low
Harris Hip Score (follow-up 1 year)8774N/AMD -6.8 (-12 to -1.6)Moderate
Harris Hip Score (follow-up 2 years)7168N/AMD -3.3 (-9.1 to 2.5)Moderate
Number of patients with Barthel Index Score of 95 or 100 (follow-up 1 year)31/87 (35.6%)39/73 (53.4%)RR 0.67 (0.47 to 0.95)176 fewer per 1,000 (from 27 fewer to 283 more)Moderate
Number of patients with Barthel Index Score of 95 or 100 (follow-up 2 years)24/69 (34.8%)26/68 (38.2%)RR 0.91 (0.58 to 1.42)34 fewer per 1,000 (from 160 fewer to 160 more)Moderate
Eq-5d (Euroqol) Index Score (follow-up 1 year)7062N/AMD -0.09 (-0.2 to 0.02)Moderate
Eq-5d (Euroqol) Index Score (follow-up 2 years)5252N/AMD -0.11 (-0.21 to -0.01)Moderate
Length of hospital stay486478N/AMD -0.6 (-2.04 to 0.83)Moderate

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.

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