Christiansen replacement hemiarthroplasty in femoral neck fractures of the elderly.

A total of 108 femoral neck fractures were operated on by Christiansen hemiarthroplasty. Primary mortality was 4.8%, but after an average of 61 months only one-third of the patients were alive. Sixteen of the 40 hips of the living patients showed a poor result as evaluated by the Harris score or subjective outcome. Only four hips were wholly satisfactory at follow-up. It appears that Christiansen hemiarthroplasty has no advantages over other hemiendoprosthetic devices. It is suggested that undisplaced or minimally displaced fractures should not be treated by hemiarthroplasty but by compression osteosynthesis. The problem of displaced fractures still remains open. It appears, however, that primary total hip arthroplasty should be performed in cases of rheumatoid arthritis or even initial osteoarthritis, if an endoprosthetic replacement is considered.