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

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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 yr results of screw fixation were excellent or good in 55% of the patients, fair in 17% and poor in 28%, compared to 79% excellent or good results, 13% fair and 8% poor results in the prosthetic group. As regards the initial stay in hospital, prosthetic replacement was associated with 2.4 times higher costs. This difference was reduced by a more expensive follow-up and more frequent readmissions and reoperations in the internal fixation group. Considering the total costs, prosthetic replacement was 1.6 times more expensive than internal fixation.