clinical outcomes of femoral neck fractures treated with hemiarthroplasty versus orif with fibular strut graft and screw

Femoral neck fractures are a significant cause of morbidity, particularly in the elderly population. treatment options include hemiarthroplasty (ha) and open reduction internal fixation (orif) with fibular strut graft (fsg) and screws. this study aimed to assess and contrast the clinical outcomes of these two surgical methods in patients.this retrospective study analyzed the medical records of patients who underwent either ha or orif with fsg and screws using the surabaya technique for femoral neck fractures between 2017 and 2021. clinical outcomes were evaluated based on postoperative complications and functional recovery measured by the harris hip score (hhs) and short form 36 (sf-36). all the patients were followed up at least 1 year post-operatively.the study comprised 87 patients, 50 in the ha and 37 in the fsg groups. the mean vas reduction in the ha group was 1.06 ± 0.84, compared to 1.16 ± 0.80 in the fsg and screw group. although the latter showed slightly greater pain score reduction, this difference was not statistically significant (p = 0.498). hhs scores for ha were 78.56 ± 11.84, lower than those for fsg and screw at 85.16 ± 12.01, with 80.4% in the good-to-very good category. sf-36 scores were 76.06 ± 5.79 for ha and 82.91 ± 5.96 for fsg and screw, with 93.1% overall good results. ha, fsg, and screws reduced pain significantly without notable differences. functionally, fsg and screw showed better outcomes (hhs, p=0.011; sf36, p=0.00). for femoral neck fractures, fsg and screws are viable alternatives. further research with larger samples and rcts is recommended.