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At least 667 records · Page 37Linked to original sources
PubMed2005

Femoral neck fracture in a child with autosomal-dominant osteopetrosis: failure of spica cast treatment and successful outcome by internal fixation.

A case report of a 6-year-old child with autosomal dominant osteopetrosis who sustained a closed femoral neck fracture initially treated with a spica cast with subsequent fracture displacement is presented. Further treatment included closed reduction and operative fixation, first, with a guide pin placement for a cannulated screw insertion that was abandoned because of the hardness of the bone. Three Kirschner wires were then inserted to maintain the closed reduction, followed by immobilization in a spica cast. At the 2-year follow-up, the child was completely free of any complications resulting from her injury and treatment. Radiographs showed no evidence of avascular necrosis in the affected femoral head. Review of the literature supports evidence for early operative fixation of such cases, whether or not the femoral neck fracture is nondisplaced or displaced.

Casts, Surgical↗
PubMed1982

Femoral neck fractures in young adults.

A total of 110 fractures of the neck of femur were studied in 108 patients 17 to 50 years old. The aims were to analyze why these fractures occur in young adults, and what results can be expected after internal fixation. Severe trauma caused about half of the fractures. In the remaining group chronic and disabling disorders were usually present at the time of injury. Seventeen patients were known to abuse alcohol. Aseptic necrosis with late segmental collapse occurred in 41 per cent of the hips (45/110), comparatively more often in patients who were 45 years or younger. Only 16 of the 73 patients who were seen at follow-up (22 per cent) had a perfect result. It is concluded that femoral neck fractures in patients younger than 45 years occur because of significant trauma in a healthy subject, or minor trauma in subject with predisposing disease. The incidence of late segmental collapse is greater than in elderly patients with femoral neck fractures. A less satisfactory result can therefore be expected.

Accidents, Traffic↗
PubMed1991

[Osteosynthesis of medial femoral neck fractures with 2 Hansson nails].

From 1.1.1986-31.12.1987 we treated 78 fractures of the femoral neck with two Hansson nails in the Department of Orthopedic Surgery in the County Hospital in Roskilde. All cases were evaluated after two years. Fifteen patients had died (19.2%). Seventeen patients had had a secondary operation (21.8%). Secondary total hip replacement was performed in 19.2% of the patients, all of whom had primarily had a displaced fracture. There was one incident of deep infection, otherwise the rate of complications was low. The duration of the osteosynthesis operation was short and patients were discharged early from hospital. After two years, 31 patients were reexamined radiologically and clinically. The results were satisfactory in all cases. The method of osteosynthesis is recommended as a simple procedure with good results.

Adolescent↗
PubMed1993

[Osteosynthesis in dislocated femoral neck fracture (Garden 3 and 4). Long-term results and treatment concept].

The dislocated fracture of the femoral neck (Garden type 3 and 4) in the young patient is preferably treated by open reduction and internal fixation. In the period 1980-1989 we fixed 49 fractures with a dynamic hip screw, a 130 degrees-angled plate, screws alone, or by a valgisation osteotomy fixed with a 120 degrees-plate (Pauwels osteotomy). 30 fractures were reviewed after 66 months in average. We observed radiological signs of femoral neck necrosis in 9 patients, thereof 7 with symptoms, and radiological signs of osteoarthritis in 3 patients, two with symptoms. The possible factors causing these late complications are discussed. We advocate the immediate open reduction to evacuate the intracapsular hematoma into a slight valgus over-correction for stability. For the fixation we use 3 screws in good bone quality, the dynamic hip screw and the angled plate in osteoporotic bone often combined with an accessory screw for rotational stability. The functional long-term result was good or excellent in 70%. By avoiding technical errors this rate can be improved.

Female↗
PubMed2006

[Effects on biomechanical properties of hip articular cartilage degeneration following the femoral neck fracture in rabbits].

Osteotomies were performed through post-lateral approach under the base of femoral neck on 60 New Zealand white rabbits. The changes of the thickness and biomechanical properties of acetabular cartilage following the cartilage degeneration and the relationship to the postoperative time 2, 4, 6, 8, 12, 16 weeks later were measured respectively. The cartilage specimens were harvested and measured by the automated creep indentation apparatus to obtain the thickness and biomechanical properties. The cartilage became thicker within 6 weeks after operation, cartilage degeneration developed critically from the surface with the lost of the biomechanical properties. The degeneration progressed till the eartilage became thinner and thinner and the to be torn out into pieces at last. The matrix of articular cartilage degraded markedly for the absence of normal stress load following the femoral neck fracture, led to the decline of the biomechanical properties and kept the degeneration progress to osteoarthritis.

Animals↗
PubMed1992

[Bipolar prosthesis in femoral neck fractures. Results and long-term acetabular tolerance of 36 bipolar arthroplasties].

The authors present the long-term results of 36 SEM cemented bipolar hip prostheses for femoral neck fractures with a mean observation time of 7.4 years. The objective was to study the acetabular tolerance of these prostheses comparing with Moore's and Thompson's conventional hemiarthroplasties. The average age of the patients was of 69 years. According to the Merle d'Aubigné's classification, clinical results were better than those results reported in the literature with conventional hemiarthroplasties. At long term, acetabular deteriorations were nevertheless frequent (41.6 per cent pinchings and 25 per cent protrusions), but with no clinical significative correlation. They seem to be favoured by technical errors (drilling, size of the cups) and acetabular morphology. The part of the intermediary joint's mobility is difficult to demonstrate and is far being univocal. The authors conclude, to the superiority of the bipolar hip prosthesis actually totalizable (long term clinical results and middle term acetabular tolerance) in comparison with the conventional hemiarthroplasties, and recommend the use of those implants in sub-capital displaced femoral neck fractures for elderly patients with no arthrosis.

Acetabulum↗
PubMed2002

Vertebral body fracture of the lumbar spine in elderly women: more severe in osteoarthritis of the knee than in femoral neck fracture.

This study investigated bone fragility by comparing fractures of the vertebral body of the spine in elderly women receiving total knee replacement (TKR) (group 1) due to severe osteoarthritis of the knee and those with femoral neck fractures (group 2) attributable to osteoporosis. Forty-two women each were selected retrospectively for group 1 and prospectively for group 2. Patient age ranged from 64-83 years. Vertebral body fractures of the lumbar spine were significantly more severe in group 1 than in group 2 (P<.001). Patients undergoing TKR due to osteoarthritis of the knee had systemic bone fragility, which included the spine.

Absorptiometry, Photon↗
PubMed1986

Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty.

A prospective study of displaced femoral neck fractures was conducted with patients randomized into three groups: cemented total hip replacement (THR), cemented hemiarthroplasty (UHR-C), and noncemented hemiarthroplasty (UHR-NC). Eighty-nine patients were treated for displaced (Garden type 3 or 4) fracture with a prosthesis; 39 patients had THR, 37 had UHR-C, and 13 had UHR-NC. No difference was found in the level of pain, ambulation, or aids required between the THR group and the UHR-C group, except for active community ambulators, who demonstrated decreased endurance capability when treated with UHR-C. The patients treated with UHR-NC had increased pain and decreased ambulation and required assistive devices. The most significant complication was dislocation, which occurred in 7 patients with THR and 2 with UHR-C. The mortality rate at 2 years was 18%; all but two of the deaths were in patients with one of five different medical diseases: clinically significant cardiac or pulmonary disease, cancer, alcoholism, or psychosis. The mortality rate was insignificant in patients younger than 70 years of age. Roentgenographic review showed only 2 of 76 cemented stems with progressive cement-bone demarcation, with one patient requiring revision for a loose prosthesis. No evidence of protrusio was seen with the use of the bipolar cap. The uncemented hemiarthroplasties demonstrated lucency between the metal and bone in the proximal femur in 9 of 13 stems. The authors make recommendations regarding hip replacement.

Adult↗
PubMed1980

The role of posterior bone grafts (muscle-pedicle) in femoral neck fractures.

Mastering the muscle-pedicle technique and adhering to the principles of accurate reduction, impaction of the fracture fragments, and secure fixation should result in significant improvement in the rate of osseous union and marked reduction in late segmental collapse after treatment of displaced femoral neck fractures.

Adult↗
PubMed1990

Experience with bipolar prosthesis in femoral neck fractures in the elderly and debilitated.

Eighty-eight bipolar Bateman hip endoprostheses for medial femoral neck fractures were implanted. The average age of the patients was 75 years. Intrahospital results proved the morbidity and mortality rates to be well within acceptable limits. Thirty patients were followed during periods of 12-74 months (median, 33 months). According to Charnley evaluation, mobility was excellent and very good in 20 patients (86%). Good function was present in 63% of patients. The majority of patients belonged to category C as defined by Charnley. Mild pain was present in 19 patients (63%); in only two cases, involving severe rheumatoid arthritis, pain was clearly related to sinkage. Radiographically, no visible protrusion or socket wear was present. Periarticular ossification occurred in 19 patients, but this did not impair function.

Aged↗
PubMed1990

Fixation of 220 femoral neck fractures. A prospective comparison of the Rydell nail and the LIH hook pins.

220 patients with femoral neck fractures were randomly treated with either a Rydell nail (n 110) or two LIH hook pins (n 110). The age, sex, and displacement patterns were similar in both group. All the patients were operated on by orthopedic specialists and followed clinically and radiographically for 2 years or until death. The mortality at 2 years was similar (28 percent) in both groups. Among 154 survivors, early redisplacement or nonunion was recorded in 19 percent of the Rydell-nailed fractures and 32 percent of the LIH-pinned fractures. In nondisplaced fractures, complications occurred in 8/30 Rydell cases compared with 3/16 in the LIH group. In displaced fractures, complications occurred in 21/48 Rydell cases compared with 28/60 in the LIH group.

Adult↗
PubMed2006

Valgus intertrochanteric osteotomy for non-union of femoral neck fracture.

In spite of improved surgical techniques and fixation devices, non-union still reportedly occurs in 10-30% of cases of femoral neck fracture. A variety of methods of treatment that preserve the femoral head have been described, yet there are few reports on the results of valgus intertrochanteric osteotomy in cases of femoral neck non-union. We treated 11 such cases with valgus intertrochanteric osteotomy performed at one centre and using a single surgical technique. The cases were evaluated clinically and radiographically at a mean of 4.9 years. All of the non-unions were shown radiographically to have healed by an average of 12.5 weeks. Functional outcome was excellent for nine patients and poor for two who underwent subsequent total hip arthroplasty for avascular necrosis of the femoral head. We conclude that valgus intertrochanteric osteotomy is an effective treatment for femoral neck non-union, but avascular necrosis of the femoral head is a possible complication.

Adult↗