Primary and secondary Charnley-Hastings hemiarthroplasty in displaced femoral neck fractures and their sequelae.

: 298 women and 36 men, median age 80 (range 40-95) years with 340 femoral neck fractures were treated with Charnley-Hastings hemiarthroplasty and followed for 41 (range 12-86) months. 107 replacements were primary because of poor reduction and 233 were secondary, performed during 60 months after the injury because of disturbed fracture healing. The results of primary and secondary replacements regarding morbidity, mortality, prosthesis failure and survival were similar. The major postoperative complications were: early wound infection (10 cases, 2.9%), dislocation of the prosthesis (16 cases, 4.7%), fracture of femoral shaft (nine cases, 2.7%), and loosening of components with reoperation (six cases, 1.8%). In total 33 reoperations (9.7%) were performed. When failure of the prosthesis was defined as dislocation, fracture or removal of part or whole prosthesis, the three-year and six-year survival rates were 89 and 80%, respectively. Defining the failure as removal of prosthesis component(s) only, the success rates were 96 and 94%, respectively. We conclude that cemented bipolar prosthesis offers a good alternative for salvage of displaced or failed femoral neck fracture.