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At least 649 records · Page 36Linked to original sources
PubMed1985

Rehabilitation after femoral neck fracture. 3053 patients followed for 6 years.

The rehabilitation of 3053 consecutive patients with femoral neck fractures from Stockholm County was followed up for 6 years. Of the patients 79 per cent were admitted from home. The majority of these patients returned home within 6 months, but patients from the city did so more slowly than patients from rural areas, and with increased secondary rehabilitation measures. Patients treated in general surgical units stayed longer and utilized more secondary rehabilitation resources than those treated in orthopaedic units. At 1 year most differences were equalized.

Activities of Daily Living↗
PubMed1991

Stability of femoral neck fracture. Roentgen stereophotogrammetry of 29 hook-pinned fractures.

The stability of hook-pin fixation during weight bearing was studied in 29 femoral neck fractures using roentgen stereophotogrammetric analysis. Twenty-three fractures became stable within 1 to 9 months, whereas redisplacement or continuing movement of the fracture occurred in 6 cases. Displaced fractures shortened about 7 mm more than undisplaced ones before healing. The rotations of the femoral heads were greatest in the forward/backward direction, followed by varus-valgus tilting in both fracture groups. Rotation about the longitudinal axis was recorded in the displaced fractures, mainly as a retroversion, whereas no rotation occurred about this axis in the undisplaced fractures. Healing after 6 months, intermediate fracture fragments, and a decreased Pauwels' angle seemed to imply increased fracture compression or rotatory instability. Fractures that subsequently developed healing complications displayed an increased distal displacement of the femoral head during the first postoperative month.

Adult↗
PubMed1979

[Late results of the operated patients with femoral neck fractures. results of the a-o technique and the endoprosthesis from 3 to 5 years after operation (author's transl)].

The late results of 133 operatively treated patients with femoral neck and trochanteric fractures were evaluated. The series consisted of 86 women and 47 men, 72 femoral neck fractures and 61 trochanteric fractures. 99 patients were treated by A-O osteosynthesis and 34 by endoprosthesis. The average age of the group with osteosynthesis was 71 and of the group with endoprosthesis 76 years. From 3 to 5 years after the operation the nailing results of the patients with femoral neck fractures were poor in 7.1 and with trochanteric fractures in 15.4 per cent. During the same observation period the results of the patients treated with endoprosthesis were poor in 14.3 per cent. There were no statistically significant difference between the A-O group and the endoprosthesis group with femoral neck fractures. Between the mortality of the nailed patients with femoral neck fractures and the endoprosthesis group there was no statistically significant difference.

Adult↗
PubMed1982

Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial.

In a clinical, controlled trial 112 patients with fresh femoral neck fractures were allocated to two groups of treatment: 55 patients had a Moore hemi-arthroplasty cemented with methyl methacrylate and 57 patients a non-cemented prosthesis. 75 patients attended the follow-up study. At 6 weeks, 3 months, 6 months and 12 months after the operation the function of the hip was assessed according to Merle d'Aubigné. At 6 weeks, 3 months and 6 months after the operation the clinical results were significantly better among patients with cemented prosthesis, especially in relation to pain relief and gait function. It is concluded that fixation of the prosthesis with cement improves the clinical results, at least during the first 6 months following the operation.

Aged↗
PubMed1977

Immediate weight-bearing after internal fixation of the femoral neck fractures using von Bahr screws. Preliminary report of a prospective clinical trial.

Osteosynthesis of displaced femoral neck fractures using von Bahr screws was performed in 50 patients. Immediate postoperative weight-bearing was allowed. After a follow-up period of 1 year a high incidence (20 per cent) of early failure (dislocation of the fractures with or withour screw movement) was found. Analysis of the material showed that the failure rate was influenced by the peroperative reposition of the fracture, especially the valgus/varus position of the caput fragment, and the position of the screws.

Adolescent↗
PubMedDate not supplied

Femoral neck fracture in a child with autosomal dominant osteopetrosis.

A child with autosomal dominant osteopetrosis had successful treatment of a femoral neck fracture by internal fixation. Drilling the pins into the femoral neck was extremely difficult. The histopathology in osteopetrotic bone provides a probable explanation for the technical difficulty seen in this case.

Child↗
PubMed2001

[Repositioning femoral neck fracture in younger patients. Valgus or anatomic reposition?].

In a retrospective study, 51 patients with femoral neck fractures received open reduction and internal fixation. They were divided into two groups. Group A included all patients treated with anatomical reduction. In Group V, the bone fragments were positioned in > or = 5 degrees valgus. The median age of the patients was 37.4 years (range 13-58). 51 patients were available for follow-up assessment at 10.1 (+/- 4.3) years. There were 33 patients in Group A and 18 in Group V. All patients were examined with regard to early and long-term complications. In the first five years, avascular necrosis was seen in 18% in Group A and not at all in Group V. Nonunion occurred in 9% of Group A and 5.5% of Group V. On average at 10 years after the operation, coxarthritis (Kellgren 2) was evident in 21.2% of Group A and 55.6% of Group V (p = 0.04). According to the Hip-Score of Merle d'Aubigné, the patients treated with anatomical reduction had a better functional outcome after 10 years. With respect to the results we recommend in younger patients (< 60 years) anatomical reduction in Pauwels I and Garden-II-fractures. Valgusreduction should be performed as well in Pauwels II and III as Garden-III-and-IV-fractures.

Adolescent↗
PubMed2003

Treatment of displaced femoral neck fractures: a randomized minimum 5-year follow-up study of screws and bipolar hemiprostheses in 100 patients.

In a randomized study of 100 patients having displaced femoral neck fractures (Garden types 3-4), we compared internal fixation using 2 von Bahr screws (n = 53) with a bipolar Variokopf prosthesis (n = 47) . The duration of surgery was shorter and the blood loss was less in the group with screws. Dislocation of the prosthesis occurred in 7/47 patients, all within 4 months. After a minimum follow-up of 5 years, 34 of 53 patients had been reoperated on in the screw group and 3/47 patients in the prosthesis group. No differences in patient mortality were noted between the groups after 2 or 5 years. The bipolar prosthesis seems to be a suitable alternative for primary treatment of displaced femoral neck fractures.

Aged↗
PubMed1989

Function after hook-pin fixation of femoral neck fractures. Prospective 2-year follow-up of 191 cases.

Totally, 191 consecutive patients with femoral neck fractures during 1984 and 1985 had internal fixation with hook-pins and were prospectively investigated. Within 2 years, 62 patients had died and 47 had developed healing complications, 30 of whom had been treated with total hip replacement. Thus, 82 healed without complication. Forty-one of 47 patients without other handicaps affecting their walking ability considered their gait as good as it was preoperatively; 45 used no walking aids or a cane. Nine of 35 patients with a nonfracture-related disease affecting their walking ability managed to walk with or without a cane; 13 considered their walking ability unaltered compared with their prefracture state. Three of 82 patients complained of pain on walking and 2 of pain at rest. All but 1 could flex their hip 90 degrees or more. We believe that the function after internal fixation of cervical hip fracture with uncomplicated healing is superior to that achieved by primary hip replacement; primary replacement is recommended only in rheumatoid patients with displaced fractures.

Adult↗
PubMed1995

Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

Bone Plates↗
PubMed1986

[Pohl's track screw for the surgical treatment of femoral neck fracture. Reliable surgical principle or obsolete method?].

Pohl's hip screw--the classic form of a dynamic osteosynthesis--is an approved method in the treatment of the fracture of the femoral neck (lateral and pertrochanteric fractures). Between 1963 and 1983 over 200 patients were treated with Pohl's hip screw. At an averaged stay of 29 days in hospital half of them were rehabilitated. The mortality rate was 9.3%. More recent methods--e.g. the dynamic hip screw, propagated by AO--present more technical improvements but they are only variations of an old therapeutic principle proved over a generation.

Aged↗
PubMed1991

[Superselective intra-arterial DSA in femur head necrosis and femoral neck fractures].

The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA--after pedicled pelvic bone graft--revealed a regular arterial graft perfusion in 82%.

Adult↗
PubMed1981

[The mechanical properties of devices used for the fixation of femoral neck fractures (author's transl)].

The authors have studied the mechanical problems of internal fixation of femoral neck fractures, both from the theoretical and experimental point of view. They have tested stability of several types of fixation according to the obliquity of the fracture line. Three types of strain have been applied to fractured dried bone. Fixation by three parallel screws seemed to give the most stability. The authors conclude that, with this type of fixation, early weight-bearing can be resumed by patients with fractures of Pauwels type I and II, but weight-bearing is still dangerous in type III.

Biomechanical Phenomena↗
PubMed1983

Avascular necrosis associated with nailing of femoral neck fracture. Two cases examined pre- and postoperatively by tetracycline and radionuclide tracer techniques.

Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. Sr85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occurred during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures.

Adult↗
PubMed1995

Quality of reduction and cortical screw support in femoral neck fractures. An analysis of 72 fractures with a new computerized measuring method.

The aim of this study was to compare the quality of reduction and the position of the fixating screws with the rate of union in 72 femoral neck fractures. The degree of fracture displacement after reduction and the position of the two fixating screws were determined with a new computerized measuring method that compensates for the variations in hip rotation in routine radiographs. All 13 nondisplaced fractures united. Sixteen of 18 fractures healed in the group of displaced fractures where both the fixating screws were placed within 3 mm from the femoral neck cortex, compared with 13 of 22 healed fractures in the group where only one screw had the same close contact with the femoral neck cortex (p < 0.05). Nonunion developed in all five displaced fractures where none of the two fixating screws were placed within 3 mm from the femoral neck cortex. The quality of reduction did not affect the healing rate; however, the number of poorly reduced fractures was only 10%. The results of this study underline the importance of achieving cortical support for the fixating screws in femoral neck fracture surgery.

Aged↗