Factors associated with avascular necrosis of the femoral head and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation

2012 ◽  
Vol 23 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Daniel Schweitzer ◽  
Patricio Melero ◽  
Alejandro Zylberberg ◽  
Julian Salabarrieta ◽  
Julio Urrutia
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Avascular Necrosis ◽  
Femoral Neck Fractures ◽  
Factors Associated ◽  
Displaced Femoral Neck Fractures

Displaced femoral neck fractures in patients 60 years of age or younger: results of internal fixation with the dynamic locking blade plate

2018 ◽  
Vol 100-B (4) ◽  
pp. 443-449 ◽  
Author(s):  
J. H. Kalsbeek ◽  
A. D. P. van Walsum ◽  
J. P. A. M. Vroemen ◽  
H. M. J. Janzing ◽  
J. T. Winkelhorst ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Avascular Necrosis ◽  
Young Patients ◽  
Case Series ◽  
Neuromuscular Disorder ◽  
Femoral Neck Fractures ◽  
Blade Plate ◽  
Displaced Femoral Neck Fractures

AimsThe objective of this study was to investigate bone healing after internal fixation of displaced femoral neck fractures (FNFs) with the Dynamic Locking Blade Plate (DLBP) in a young patient population treated by various orthopaedic (trauma) surgeons.Patients and MethodsWe present a multicentre prospective case series with a follow-up of one year. All patients aged ≤ 60 years with a displaced FNF treated with the DLBP between 1st August 2010 and December 2014 were included. Patients with pathological fractures, concomitant fractures of the lower limb, symptomatic arthritis, local infection or inflammation, inadequate local tissue coverage, or any mental or neuromuscular disorder were excluded. Primary outcome measure was failure in fracture healing due to nonunion, avascular necrosis, or implant failure requiring revision surgery.ResultsIn total, 106 consecutive patients (mean age 52 years, range 23 to 60; 46% (49/106) female) were included. The failure rate was 14 of 106 patients (13.2%, 95% confidence interval (CI) 7.1 to 19.9). Avascular necrosis occurred in 11 patients (10.4%), nonunion in six (5.6%), and loss of fixation in two (1.9%).ConclusionThe rate of fracture healing after DLBP fixation of displaced femoral neck fracture in young patients is promising and warrants further investigation by a randomized trial to compare the performance against other contemporary methods of fixation. Cite this article: Bone Joint J 2018;100-B:443–9.

216 Fix or Replace: Is Internal Fixation Still A Viable Option in The Elderly with Un-Displaced Intracapsular Femoral Neck Fractures?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Morris ◽  
A Krishna ◽  
H Hamid ◽  
M Chawda ◽  
H Mumtaz
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Revision Surgery ◽  
Retrospective Review ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Type I ◽  
Cannulated Screws ◽  
Viable Option ◽  
Displaced Femoral Neck Fractures

Abstract Aim The treatment of impacted or un-displaced femoral neck fractures in the elderly osteoporotic patient is still largely debated, with arthroplasty versus internal fixation two surgical options1. Our aim was to retrospectively review patients over the age of 80 with un-displaced intracapsular hip fractures who had undergone internal fixation and assess their rate of mortality and revision surgery. Method We conducted a retrospective review of all patients with femoral neck fractures over a 4-year period between January 2015 to December 2018. We refined this to only patients over the age of 80 with un-displaced intracapsular femoral neck fractures fixed with cannulated screws. We noted their mental and mobility status, their follow-up attendance over 3 years, their mortality and rate of revision surgery. Results There were a total of 1232 femoral neck fractures in a 4-year period. Of these, 37 were >80 with un-displaced intracapsular femoral neck fractures, with 23 fixed with cannulated screws and 14 with a Dynamic Hip Screw. Mean age – 85, M:F (1:4.75). All patients were either Garden Classification Type I or II. 4% had cognitive impairment. All patients were independently mobile. 83% were followed up for 3 years, with 1 patient (4%) undergoing revision surgery 3 years following cannulated screw fixation. The 30-day mortality rate was 5%. Conclusions The treatment choice for un-displaced intracapsular femoral neck fractures in the elderly remains debateable. Our retrospective review shows that the rate of re-operation is low in patients who have undergone fixation with cannulated screws and so this remains a viable option.

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