Internal Fixation Versus Endoprosthesis in the Treatment of Femoral Neck Fractures in the Elderly: A Prospective Analysis of the Comparative Costs and the Consumption of Hospital Resources

Abstract

The consumption of hospital resources and the costs involved in treating femoral neck fractures in the elderly were studied and a comparison was made between internal fixation (von Bahr screws) and primary prosthetic replacement (Christiansen's endoprosthesis). the 1-year results of screw fixation were excellent or good in 55 per cent of the patients, fair in 17 per cent and poor in 28 per cent, compared with 79 per cent excellent or good results, 13 per cent fair and 8 per cent poor results in the prosthetic group. As regards the initial stay in hospital, prosthetic replacement was found to be associated with 2.4 times higher costs. This difference was reduced, however, by a more expensive follow-up and more frequent readmissions and reoperations in the internal fixation group. Considering the total costs, prosthetic replacement was found to be 1.6 times more expensive than internal fixation.

Key Words:

• cost analysis
• femoral neck fractures
• internal fixation
• prosthetic replacement