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  4. Vol 7, Issue 2, 2026

A Comprehensive Review on the Surgical Management of Femoral Neck Fractures: A Synthesis of Evidence for Internal Fixation Versus Joint Replacement

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DOI: 10.23977/medsc.2026.070203 | Downloads: 2 | Views: 74

Author(s)

Cheng Weiqiang 1

Affiliation(s)

1 Guangzhou Heping Orthopedic Hospital, Guangzhou, 510000, Guangdong Province, China

Corresponding Author

Cheng Weiqiang

ABSTRACT

Current high-level evidence mandates a patient-stratified therapeutic strategy for femoral neck fractures, demonstrating that arthroplasty—particularly using cemented prostheses—significantly outperforms internal fixation (IF) regarding long-term functional outcomes and reoperation rates in elderly patients with displaced fractures. While Total Hip Arthroplasty (THA) yields superior functional results for active individuals or those with pre-existing arthritis, Hemiarthroplasty (HA) remains the optimal low-risk intervention for frail, low-demand patients. Conversely, IF is clinically indicated primarily for non-displaced fractures or physiologically young patients requiring femoral head preservation, despite a markedly higher risk of treatment failure secondary to nonunion and avascular necrosis. Consequently, surgical decision-making should be individualized based on physiological age, fracture displacement, and pre-injury functional demand to minimize complications and optimize quality of life.

KEYWORDS

Femoral neck fracture; Arthroplasty; Internal fixation; Total hip arthroplasty; Hemiarthroplasty

CITE THIS PAPER

Cheng Weiqiang. A Comprehensive Review on the Surgical Management of Femoral Neck Fractures: A Synthesis of Evidence for Internal Fixation Versus Joint Replacement. MEDS Clinical Medicine (2026). Vol. 7, No.2, 14-20. DOI: http://dx.doi.org/10.23977/medsc.2026.070203.

REFERENCES

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