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A new NIHR funded trial will compare whether either fixing the broken bone or replacing the hip joint gives a better result for people over 60

Hip pain © Twinsterphoto/Shutterstock

Every year around 70,000 people in the UK, and 1.3 million globally, break their hip. Facing increasingly ageing populations these numbers are projected to rise to more than 100,000 by 2020 in the UK. The problem is estimated to cause the loss of 1.75 million disability adjusted life years per year globally, and represents 1.4% of the total healthcare burden in established market economies.

A new study, FRUITI, will look at treatments for one specific type of hip fracture. Minimally displaced intracapsular fractures, those that occur at the head of the femur, and may have loss of blood supply to the bone, represent approximately ten to fifteen per cent of all hip fractures. Currently, there are two treatments available. Surgeons either repair the fracture with screws or remove and replace the broken piece of bone, but it's not known which is better for patients.

Xavier Griffin, Associate Professor of Trauma Surgery at NDORMS, University of Oxford, explained: "Treatment of this type of fracture by fixing the broken bone is a quick procedure which has the advantage of preserving the patient's own hip joint. However, healing can be unsuccessful with patients requiring revision surgery in perhaps 30% of cases. Hip replacement surgery eliminates the risk of fixation failure as the femoral neck is replaced. But it is a more major operation with very significant complications of its own including a greater risk of infection, dislocation and periprosthetic fracture."

Developed by a team of patient representatives, clinical experts in trauma orthopaedics, study management specialists, experienced statisticians and health economists, the study will compare the two treatments for people 60 years and over. They will recruit 878 people to the study from 40 hospitals across the UK, and review patients health, walking ability and other daily activities, as well as any complications and specific costs at the outset, and at 6 weeks, 4 months and 1 year after the injury.

Fruiti is funded by the National Institute for Health Research (NIHR).