De mediale collumfractuur

• Non-displaced fractures of the femoral neck are generally internally fixated while preserving the femoral head.
• The current guideline states that conservative treatment of non-displaced (impacted) femoral neck fractures may be considered in patients with a 'healthy' patient profile and in patients who have already borne weight on the broken hip.
• This literature review shows that conservative treatment of patients with impacted hip fractures fails in approximately 30% of the cases.
• In most cases, patients in whom conservative treatment has failed will receive a femoral neck prosthesis or total hip replacement.
• The placement of femoral neck prosthesis has a higher surgical and anaesthesiological risk compared to internal fixation of the non-displaced femoral neck fracture.
• Given the quality of surgical techniques and improvement in perioperative care, the operative risk is limited and direct internal fixation should be strongly considered for non-displaced femoral neck fractures in all patients whose life expectancy is longer than 2 weeks.

Conflict of interest: none declared. Financial support: none declared.