Intracapsular fractures, including femoral neck fractures, typically disrupt the blood supply to the femoral head and are associated with nonunion and avascular necrosis. Thus, hemi- or total hip arthroplasty (Figure 5) is preferred over screw fixation in patients > 70 years of age with displaced femoral neck fractures to minimize these complications [1,2]. Meanwhile, extracapsular fractures, including intertrochanteric and subtrochanteric fractures, have an adequate blood supply and typically heal well after fixation with plates, sliding hip screws, or intramedullary nails [1,2].
Figure 5: Femoral neck fracture status post hemiarthroplasty. Authors’ own image.