Background: This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral\nneck fractures.\nMethods: Meta-analysis was performed on the difference in revision rate and overall mortality between participants\nundergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA.\nResults: Pooled direct and indirect results indicated no significant difference in mortality between THA and\nHA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17,\n95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74;\nP = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA\nand HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.\n34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA\nthan osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition\nin inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA,\nHA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and\nTHA had significantly lower revision rates compared with osteosynthesis.\nConclusions: There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA\nand THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide\nsupport for the use of hip arthroplasty to treat displaced fractures of the femoral neck.
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