< 60 with good bone stock and preserved joint space
Union rates increased with anatomical reduction
Options
- closed reduction
- open reduction / if closed reduction fails
Accept
- no varus
- < 15o valgus
- < 10o AP plane
Fracture distal to articular surface & proximal to intertrochanteric region
On average 4 years younger than intertrochanteric fracture
One year mortality as high as 36%
Only 1/3 will return to pre-fracture living environment
Patient > 70
Gjertsen et al JBJS Am 2010
- 4335 patients > 70 with displaced subcapital fractures
- minimum 1 year follow up
- 1 year mortality same in each group / 25%
- 22% reoperation in ORIF v 3% in hemiarthroplasty
- more pain / higher dissatisfaction / lower quality life in ORIF group
Hemiarthroplasty
- unipolar monoblock
- unipolar modular