En registerrandomiserad studie - Skruvar eller höftprotes vid fraktur på lårbenshalsen hos äldre patienter med ringa felställd fraktur.

Tidsperiod: 2019-01-01 till 2021-12-31

Projektledare: Olof Wolf

Medarbetare: Nils Hailer, Olof Sköldenberg, Jörg Schilcher, Michael Möller, Sebastian Mukka

Finansiär: Vetenskapsrådet

Bidragstyp: Stöd till forskningsmiljö

Budget: 10 257 922 SEK

Background and aimFemoral neck fractures (FNFs) are a great challenge for today´s healthcare and they are associated with high mortality and morbidity in the elderly. The treatment of displaced FNF has been investigated extensively and evidence indicate that arthroplasty outperforms internal fixation (IF) regarding clinical outcome for elderly patients. Undisplaced FNFs (uFNFs) are less investigated. The main treatment method is IF with screws although there is a reported complication rate of 9-18%.The aim of this study is to determine whether we can improve the treatment of elderly patients with an uFNF by decreasing reoperation rates through replacing the hip instead of trying to preserve it. Methods and patientsPopulation: 1440 patients aged ≥75 years with an uFNF will be randomized in the Swedish Fracture Register.Intervention: Arthroplasty (hemi or total)Comparison: Closed reduction and IF with 2-3 screws/pinsOutcome:    Primary – Composite variable comprising reoperation rate and mortality 1-year post-surgery.SignificanceThe findings of this study could lead to a change in clinical routine that would reduce the rate of reoperations in this large and fragile population, as well as improve cost-effectiveness and patient-reported outcome.