AB114. SOH25_AB_379. Operative management of minimally displaced neck of femur fractures: a 10-year retrospective cohort analysis of practice at Connolly Hospital Blanchardstown
Orthopaedic Session I

AB114. SOH25_AB_379. Operative management of minimally displaced neck of femur fractures: a 10-year retrospective cohort analysis of practice at Connolly Hospital Blanchardstown

Kurdo Araz1, Mohamed Ismael1, Abdul Wadood Thaku2, Adrian Cassar Ghieiti2, Shahril Sharaani2, Yasir Hammad2, Patrick Groarke2, Paddy Kenny2

1School of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland; 2Orthopaedics Department, Connolly Hospital Blanchardstown, Dublin, Ireland

Background: The increasing prevalence of hip fractures in Ireland, driven by an ageing population and conditions like osteoporosis, highlights a growing healthcare challenge. Among these, minimally displaced intracapsular neck of femur fractures account for 10% of cases. Management options include cannulated screws, dynamic hip screws (DHSs), intramedullary nails (IMNs), hemiarthroplasty, or total hip replacement (THR). Over the past decade, surgical trends have shifted from DHS to IMN and hemiarthroplasties, despite their higher costs and similar outcomes.

Methods: A retrospective study at Connolly Hospital Blanchardstown analysed data from 4,400 neck of femur fracture cases between 2012 and 2023, focusing on 130 patients with undisplaced intracapsular fractures treated surgically. Patients were evaluated by age, sex, transfer location, surgery timing, hospital stay, and mobility scores.

Results: Overall, 96 patients (73.8%) underwent hemiarthroplasty or THR, while 34 patients (26.2%) received internal fixation. Furthermore, 13 patients less than 70 years age underwent hip replacements instead of internal fixation. Patients undergoing hemiarthroplasty or THR were significantly older (median age: 81.0 vs. 66.5 years, P<0.001) and had longer hospital stays (8.0 vs. 5.0 days, P=0.001). However, no significant differences were observed in pre-operative new mobility scores (median 6.0 vs. 9.0, P=0.068) or postoperative ambulatory scores (median 3.0 for both, P=0.972).

Conclusions: These findings suggest that internal fixation offers comparable outcomes to hip replacements in younger patients while requiring fewer resources. Further research is needed to evaluate its suitability for patients greater than 70 years in age with minimally displaced fractures.

Keywords: Dynamic hip screw (DHS); intramedullary nail (IMN); total hip replacement (THR); hemiarthroplasty; minimally displaced intracapsular fracture

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab114
Cite this abstract as: Araz K, Ismael M, Thaku AW, Ghieiti AC, Sharaani S, Hammad Y, Groarke P, Kenny P. AB114. SOH25_AB_379. Operative management of minimally displaced neck of femur fractures: a 10-year retrospective cohort analysis of practice at Connolly Hospital Blanchardstown. Mesentery Peritoneum 2025;9:AB114.

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