Hip Fractures Clinical Trial
Official title:
Fixation Versus Arthroplasty for Undisplaced Intracapsular Fractures
In England each year over 70,000 people fracture their hip. Most of these patients are
elderly females with the fracture occurring after a simple trip or stumble. Approximately
half of these fractures are classified from their relationship to the hip joint capsule as
intracapsular. These fractures are subdivided into those that are displaced and those that
are undisplaced. The majority of displaced fractures are treated with a replacement
arthroplasty. Current treatment for the undisplaced fractures is generally by internal
fixation of the fracture using screws and a plate, although some centres prefer replacement
arthroplasty.
A recent randomised study on patients from Norway with undisplaced intracapsular fractures
treated with either internal fixation or arthroplasty has just reported reduced
complications and re-operations for those patients treated with an arthroplasty. In addition
functional results were marginally better for those patients treated with an arthroplasty.
Current practice in the UK is generally to treat these fractures by internal fixation. This
study aims to see if replacement arthroplasty can indeed lead to the advantages suggested
from the Norwegian study.
Patients who satisfy the inclusion criteria and are willing to participate will be
randomised to receive either reduction and internal fixation of the fracture with a screw
and plate device or alternatively replacement of their femoral head with an artificial hip
replacement (hemiarthroplasty). After surgery patients will receive the same treatment as
normal and be discharge home when able, with follow-up review in the hip fracture clinic.
Subsequent follow-up for the research project is by phone calls from a research nurse who is
blinded to the type of treatment that the patient has received. There will be no additional
investigations or out-patient follow-up visits for these patients in comparison to normal
treatment protocols. Results of the study will ultimately be published in a medical journal.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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