Hip resection arthroplasty as a primary treatment of displaced neck fracture in non-ambulatory and fragile patients

Due to the increasing ageing population, femoral neck fracture (FNF) is a common and significant public health issue in the elderly, as it significantly impacts patients' quality of life, frequently leading to severe disability. Undoubtedly, hip replacement is the standard current of care for displaced FNF in this population, as it can provide pain relief and allow immediate return to mobility. However, hip arthroplasty may present severe specific complications, such as implant dislocation and infection, which may increase mortality and morbidity, especially in more frail patients. Therefore, in this particular population, alternative treatments should be considered. Girdlestone resection arthroplasty, which includes excision of the femoral head, is a salvage procedure which was first described for the management of chronic tuberculous coxitis, and then widely used in uncontrolled infected hip replacements. This article provides an updated outcome analysis of hip resection arthroplasty as a primary definitive treatment for FNF in frail non-ambulatory patients.