Although the 'unsolved fracture' continues as an enigma for the orthopedic surgeon, there are certain limited indications and contraindications for the use of endoprostheses as the primary treatment of femoral neck fractures. Results can be predicted in the elderly patient. Complications are recognizable; and if the endoprosthesis fails, the patient can be effectively treated by total hip reconstruction provided that infection is absent. However, the use of an endoprosthesis in the treatment of a general neck fracture has markedly declined over the past decade. The pendulum has swung back towards internal fixation and preservation of the femoral head.
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