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Scientific Articles:
Richard Blomfeldt, Hans Törnkvist, Sari Ponzer, Anita Söderqvist, and Jan Tidermark
Comparison of Internal Fixation with Total Hip Replacement for Displaced Femoral Neck Fractures. Randomized, Controlled Trial Performed at Four Years
J Bone Joint Surg Am 2005; 87: 1680-1688 [Abstract] [Full text] [PDF]
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[Read Letter to the Editor] Dr Tidermark responds to Dr. Berry's Commentary
Jan Tidermark, Richard Blomfeldt, Hans Törnkvist, Sari Ponzer, Anita Söderqvist   (7 December 2005)

Dr Tidermark responds to Dr. Berry's Commentary 7 December 2005
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Jan Tidermark,
MD, PhD
Dept. of Orthopaedics, Karolinska Institutet at Stockholm Soder Hospital, Stockholm, Sweden,
Richard Blomfeldt, Hans Törnkvist, Sari Ponzer, Anita Söderqvist

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Re: Dr Tidermark responds to Dr. Berry's Commentary

jan.tidermark{at}sodersjukhuset.se Jan Tidermark, et al.

I wish to thank Dr. Berry for his excellent Commentary & Perspective regarding our paper. We fully share his overall conclusions but we would like to clarify one point. Besides our “intention to treat” analysis, we did, in fact, subanalyze the functional results of those patients treated with internal fixation who had no further operations and retained their femoral head. Table IV in the paper displays the outcomes for all patients without a hip complication at the 48-month follow-up. Among patients available at this follow-up, 34 out of 35 patients (97%) in the THR group and 21 out of 37 patients (57%) in the IF group remained without any hip complication. The absolute figures for hip function (Charnley score) and HRQoL (EQ-5D index score) were in favor of the THR group, although not statistically significant. Our interpretation was that a primary THR seems to provide at least as good hip function and HRQoL after four years even when compared to patients with uneventfully healed fractures after IF.