By: 1 August 2007

Orthodynamics Ltd, is a leader in providing implant solutions for complex revision hip arthroplasty. The company also has a range of primary hip, revision knee and infection control devices. In association with the BOA, the company agreed to donate the sum of £3000 as a Travel Bursary to be awarded to a Specialist Registrar on the submission to a judging panel of BOA members, an essay confirming their interest in lower limb arthroplasty.

In his seminal 1961 paper “Low angle fixation in fractures of the femoral neck”1 Garden made the bold statement that “the claim of the femoral neck fracture to being the 'unresolved fracture' is increasingly unsecure”. However 45 years later the management of subcapital femoral neck fractures remains controversial.

Fractured neck of femur is sustained in approximately 1% of all falls in the elderly2, equating to 80,0003 fractures per year in the UK. The mortality rate in the UK approaches 30% at one year3.

A literature search will reveal a plethora of published articles, reviews and meta-analysis concerning femoral neck fracture. There are 13297 indexed articles on PubMed (1950-2007) concerning femoral neck fracture.

Although it is currently widely accepted that all femoral neck fractures should be operated on if at all possible, a Cochrane review4 concluded that “Given the lack of available evidence to inform practice and the continued variation in practice