Abstract
Objective The aim of the present study was to evaluate the practices and preferences of Brazilian
orthopedic surgeons for the treatment of femoral neck fractures in middle-aged patients.
Methods A survey containing 10 images of femoral neck fractures was sent to a group of 100
orthopedic surgeons, all of them members of the Brazilian Society of Orthopedics and
Traumatology. The questionnaire asked the treatment option for cases of nondisplaced
and displaced fractures of the femoral neck in middle-aged patients, that is, those
between 50 and 69 years old. Descriptive and inferential statistical analyzes were
performed using the chi-squared (χ2) and the Fisher exact tests. The level of significance
was 5%.
Results The survey was answered by 78% of the orthopedic surgeons invited to participate
in the study. There was no significant difference in the treatment method distribution
between generalists and specialists (p = 0.16) in the sample of nondisplaced femoral neck fractures. There was a highly
significant difference in the treatment method distribution between generalists and
specialists (p < 0.0001) in the sample of displaced fractures of the femoral neck.
Conclusion Preservation of the femoral head through multiple cannulated screws fixation is the
treatment of choice for nondisplaced femoral neck fractures for both generalists and
specialists. Low chronological and/or physiological age are the main factors for this
decision-making. In displaced femoral neck fractures, femoral head replacement is
preferred for both groups of orthopedists (generalists and specialists). In this situation,
specialists prefer total hip arthroplasty (THA), whereas generalists favor partial
hip arthroplasty (PHA).
Keywords
femur - femoral neck fractures - bone screws - arthroplasty
