Trial reportBMJ (Clinical research ed.)2007
Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 104 papers, 16 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Management of Intracapsular Fractures of the Proximal Femur. A Prospective, Randomized Trial of Two Parallel Screws and Hemiarthroplasty
Hemiarthroplasty or Internal Fixation for Displaced Femoral Neck Fractures - 5 Years Follow up
Undisplaced Femoral Neck Fractures in Patients Aged 70 Years and Older: A Multicentre Randomised Controlled Trial Comparing Internal Fixation to Hemiarthroplasty
Complications and Functional Outcome of Displaced Femoral Neck Fractures Treated With Internal Fixation vs Total Hip Arthroplasty in Patients Younger Than 70 Years. A Randomized Controlled Double Blind Multi Center Trial.
Who cites it
104 citing papers in PubMed, 16 syntheses or guidelines pooled it.
- Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients.Journal of orthopaedic surgery and research · 2023Pooled it
- Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review.Journal of orthopaedic surgery and research · 2022Pooled it
- Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis.The Cochrane database of systematic reviews · 2022Pooled it
- Computer-assisted cannulated screw internal fixation versus conventional cannulated screw internal fixation for femoral neck fractures: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled it
- The choice of screw internal fixation and hemiarthroplasty in the treatment of femoral neck fractures in the elderly: a meta-analysis.Journal of orthopaedic surgery and research · 2020Pooled it
- Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Hemiarthroplasty for neck of femur fractures: to cement or not? A systematic review of literature and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Pooled it
- Is dynamic locking plate superior than other implants for intracapsular hip fracture: A meta-analysis.Medicine · 2018Pooled it
- Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis.Journal of orthopaedic surgery and research · 2017Pooled it
- Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness.Chinese medical journal · 2016Pooled it
- Meta-Analysis of a Complex Network of Non-Pharmacological Interventions: The Example of Femoral Neck Fracture.PloS one · 2016Pooled it
- Does Arthroplasty Provide Better Outcomes Than Internal Fixation At Mid- and Long-term Followup? A Meta-analysis.Clinical orthopaedics and related research · 2015Pooled it
- Which is the best alternative for displaced femoral neck fractures in the elderly?: A meta-analysis.Clinical orthopaedics and related research · 2012Pooled it
- Hip fracture.BMJ clinical evidence · 2010Pooled it
- Arthroplasty or internal fixation for displaced femoral neck fractures: which is the optimal alternative for elderly patients? A meta-analysis.International orthopaedics · 2009Pooled it
- Internal fixation versus arthroplasty for intracapsular proximal femoral fractures in adults.The Cochrane database of systematic reviews · 2006Pooled it
- High risk of positive Trendelenburg test after using the direct lateral approach to the hip compared with the anterolateral approach: a single-centre, randomized trial in patients with femoral neck fracture.The bone & joint journal · 2019Trial
- Randomized trial of hemiarthroplasty versus internal fixation for femoral neck fractures: no differences at 6 years.Clinical orthopaedics and related research · 2014Trial
- Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: a four-year follow-up of a randomised controlled trial.International orthopaedics · 2013Trial
- The effect of a pre- and post-operative orthogeriatric service on cognitive function in patients with hip fracture. The protocol of the Oslo Orthogeriatrics Trial.BMC geriatrics · 2012Trial
44 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the functional results after displaced fractures of the femoral neck treated with internal fixation or hemiarthroplasty.
designRandomised trial with blinding of assessments of functional results.
settingUniversity hospital.
participants222 patients; 165 (74%) women, mean age 83 years. Inclusion criteria were age above 60, ability to walk before the fracture, and no major hip pathology, regardless of cognitive function.
interventionsClosed reduction and two parallel screws (112 patients) and bipolar cemented hemiarthroplasty (110 patients). Follow-up at 4, 12, and 24 months.
main outcome measuresHip function (Harris hip score), health related quality of life (Eq-5d), activities of daily living (Barthel index). In all cases high scores indicate better function.
resultsMean Harris hip score in the hemiarthroplasty group was 8.2 points higher (95% confidence interval 2.8 to 13.5 points, P=0.003) at four months and 6.7 points (1.5 to 11.9 points, P=0.01) higher at 12 months. Mean Eq-5d index score at 24 months was 0.13 higher in the hemiarthroplasty group (0.01 to 0.25, P=0.03). The Eq-5d visual analogue scale was 8.7 points higher in the hemiarthroplasty group after 4 months (1.9 to 15.6, P=0.01). After 12 and 24 months the percentage scoring 95 or 100 on the Barthel index was higher in the hemiarthroplasty group (relative risk 0.67, 0.47 to 0.95, P=0.02. and 0.63, 0.42 to 0.94, P=0.02, respectively). Complications occurred in 56 (50%) patients in the internal fixation group and 16 (15%) in the hemiarthroplasty group (3.44, 2.11 to 5.60, P<0.001). In each group 39 patients (35%) died within 24 months (0.98, 0.69 to 1.40, P=0.92)
conclusionsHemiarthroplasty is associated with better functional outcome than internal fixation in treatment of displaced fractures of the femoral neck in elderly patients.
trial registrationNCT00464230.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.