Date: Sat, 22 Jan 2005 12:59:49 -0800

Subject: Femoral Neck Fracture - Ankylosing Spondylitis

From: Eitan Melamed

Dear list members,

An 80 year old woman with AS involving the hip joint sustained a base-of-neck fracture.

Any suggestions? replace or repair?

Eitan Melamed

Date: Sat, 22 Jan 2005 21:40:08 -0000

From: chris wilson

Is the hip arthritic? Is her level of function such that she is independently mobile? Is the fracture a true basi-cervical with an intact calcar? If yes to all 3, needs total hip replacement. The stiff hip will cause stress transfer to any fracture fixation and cause likely implant failure, and even if it unites, she'd still have an arthritic hip.

Regards

Chris Wilson
University Hospital
Cardiff UK

Date: Sun, 23 Jan 2005 12:18:54 -0600

From: Marc F. Swiontkowski, M.D.

Total hip replacement is the best solution.