Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 5, Issue 3 | Case Report | Open Access
Hussain Ramzan*
Omar Fayek Ismail1, Zahra Zarrinhonar2 and Hussain Ramzan3*
1University of Debrecen, Hungary
2St. George’s University, Grenada
3Nishtar Medical University and Hospital, Multan, Pakistan
*Correspondence to: Hussain Ramzan
Fulltext PDFFemoral fractures in the elderly represent a major public health crisis, driven by demographic aging and associated with devastating mortality, functional decline, and immense economic costs. The surgical decision between Open Reduction (OR) and Closed Reduction (CR) is a cornerstone of management, influencing healing biology, complication profiles, and ultimate recovery. This narrative review synthesizes contemporary evidence and guideline recommendations to compare these reduction strategies across femoral fracture patterns in older adults. For displaced femoral neck fractures, current guidelines strongly advocate for arthroplasty over internal fixation, effectively minimizing the relevance of the OR versus CR debate for fixation in this subset. In subtrochanteric fractures, the quality of the achieved reduction is a more critical determinant of union than the method used to attain it. For femoral shaft fractures, meta-analyses confirm that CR with intramedullary nailing yields superior union rates and faster healing compared to OR. In distal femoral fractures, a hybrid approach-open reduction for articular reconstruction combined with closed, minimally invasive fixation for the metaphyseal segment-is emerging as a balanced strategy. Ultimately, the choice must be integrated into a patient-centred, multidisciplinary orthogeriatric pathway to optimize outcomes in this vulnerable population.
Omar Fayek Ismail, Zahra Zarrinhonar and Hussain Ramzan. Open Reduction Versus Closed Reduction: The Management of Femoral Bone Fractures in the Elderly – A Narrative Review of Current Guidelines. Ann Case Rep Clin Stud. 2026;5(3):1-7.