Many studies show that total hip replacement (THR) for some types of hip fracture gives superior results when compared to internal fixation. Any time screws, pins, or metal plates are used to repair a hip fracture, it's called open reduction internal fixation (ORIF).

An ongoing study from Sweden compared 53 patients with THR to 49 patients with ORIF. Patients in both groups lived alone and could walk before their hip fractures. All were in good mental and physical health.

At the end of two years, the THR group had much better outcomes compared to the ORIF group. The same results were present at the end of four years. For example 42 percent of the ORIF group had hip complications requiring a second operation. This was compared to four percent of the THR group.

By the time the ORIF group was converted to a total hip, they had lost function, walking ability, and were having more pain than the THR group. Quality of life was also significantly reduced after so much pain, loss of function, and multiple operations.