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PubMed1991

Function of the hip after femoral neck fractures treated by fixation or secondary total hip replacement.

Two matched groups of 28 patients each, with femoral neck fractures treated by primary internal fixation or by secondary total hip replacement after a complication of primary treatment, were evaluated and compared five years or more after primary pin fixation or secondary total hip replacement. The Nottingham Health Profile questionnaire was sent and returned by mail and the patient groups were matched with regard to age, sex, health, and social situation. Patients with healed fractures had less problems with sleep, housework and hobbies, and thus functioned better than patients who had required a secondary total hip replacement.

Activities of Daily Living↗
PubMed1986

The Deyerle device for fixation of femoral neck fractures. A review of one hundred twenty-five consecutive cases.

One hundred twenty-five consecutive femoral neck fractures were treated with Deyerle fixation in the ten-year period from 1970 to 1980. The 123 patients in the series of 125 fractures had a mean age of 62.2 years. Sixty-nine percent of the fractures were displaced. Fewer than nine pins were used in only eight cases. In 102 cases, impaction was recorded and quantitated. Pin penetration was noted in 44 cases (35%), and infection in 14 cases (11%). Sixty-four percent of the patients were followed for at least two years; 31 (39%) developed aseptic necrosis and five (6.3%) had nonunited fractures. Owing to the risks of increased operating time, blood loss, and technical difficulties encountered in the authors' teaching hospital, the method was discontinued.

Adult↗
PubMed2002

The long-term results of Lubinus interplanta hemiarthroplasty in 228 acute femoral neck fractures. A retrospective six-year follow-up.

BACKGROUND AND AIMS: We retrospectively studied survival of patients treated with Lubinus interplanta (IP) semiendoprosthesis in acute hip fracture. MATERIALS AND METHODS: The long-term results of Lubinus interplanta (IP) hemiarthroplasty in 228 acute medial fractures of the femoral neck in 222 patients were reviewed. RESULTS AND CONCLUSIONS: The mean age of the patients was 80.3 years. The mean duration of post-operative follow-up was 6.3 years (range 5-8 years). There were 12 reoperations (5.3%), of which 8 were revisions (3.5%). Dislocation rate was 3.5%. Survival was 93% at three years and 88% at six years (Kaplan-Meier-survival analysis). CONCLUSIONS: These results surpass those previously published after Thompson and Moore hemiarthroplasties. The Lubinus prosthesis has a greater CCD (caput,collum, diaphyse) angle and a longer stem compared to Thompson and Moore implants. The need for resection of calcar cortex is also limited. These biomechanical facts may explain the good long-term results of Lubinus hemiarthroplasty.

Aged↗
PubMed1987

The healing of femoral neck fractures in dogs. The use of intraosseous venography and India ink staining.

This study evaluates healing fractures of the femoral neck in dogs by using standard radiography, intraosseous venography, India ink staining and histology. The 45 animals were divided into three groups, one of which was not treated, but in the other two the fracture was fixed with a screw or two Kirschner wires. Our results suggest that, when intraosseous venography was positive India ink injection was also positive, and the late phase of fracture healing was reached.

Animals↗
PubMed1980

Femoral neck fractures. 165 cases treated by multiple percutaneous pinning.

A prospective series of 165 displaced subcapital fractures of the femoral neck treated with reduction and percutaneous multiple pinning is presented. The method offers the advantages of a short operating time, no loss of blood, immediate weight-bearing and no infection problems. Furthermore the operative procedure can be performed under local anaesthesia. In Garden stage 3 fractures union occurred in 97 per cent and late segmental collapse in 8 per cent. In Garden stage 4 fractures union occurred in 72 per cent and late segmental collapse in 14 per cent. Failures were almost exclusively encountered in the group of poorly reduced fractures which had a failure rate of 77 per cent. In the case of non-union 75 per cent of the patients needed a secondary hip replacement whereas only 16 per cent of the patients with late segmental collapse had received an arthroplasty at the time of the follow-up.

Aged↗
PubMed1985

Mo(o)re or less prostheses--retrospective study of 166 dislocated femoral neck fractures treated by the Moore endoprostheses.

Moore's endoprosthesis is still often used to treat (dislocated) medial femoral neck fractures. It appears from this retrospective investigation of 166 patients that while the results obtained with elderly patients are not unsatisfactory, only 16% of the patients under 70 years of age were complaint free after more than four years time. Therefore, it is recommended that 'head-neck' prostheses be only used in older people with limited life expectancies. A significant difference with other cemented or double articulated prostheses was not demonstrated.

Aged↗
PubMed1996

[Combined total endoprosthesis implantation in bilateral femoral neck fracture with osteogenesis imperfecta tarda].

Osteogenesis imperfecta tarda is a hereditary disease with an insufficiency of osteoblasts caused by a collagen disorder, insufficient formation of osteoid and an impediment of periosteal bone formation. This leads to increased fragility of the bones and, as a consequence, to the risk of fractures. We report a simultaneous, bilateral medial femoral neck fracture, caused by a cerebral cramp attack. The patient is 80 years old and suffers from osteogenesis imperfecta tarda and Parkinson's disease. We implanted a cemented total endoprosthesis on each side in just one operation. There were no complications in the intra- and postoperative course. A walking aid gradually increased the patient's mobility so that he could be discharged on the 21st postoperative day.

Aged↗
PubMed1994

[Prediction of segmental collapse of femoral head after femoral neck fracture by scintimetry].

A follow-up study regarding the occurrence of segmental collapse of femoral head has been done in 53 patients of united femoral neck fracture including a periodic examination by 99mTc-MDP scintimetry. The results showed that the sequential variations in the nuclide uptake ratio of the femoral heads could reflect the histological repairing process and metabolic level in the femoral head. A sustainedly high nuclide uptake in 12 months after operation often denotes that there are defects in the repairing process of the ischemic femoral head, and that the segmental collapse of the femoral head will ensue.

Adolescent↗
PubMed1997

Percutaneous cannulated screw fixation of femoral neck fractures: the three point principle.

Out of a total of 183 patients with displaced intracapsular fractures of the femoral neck, 40 were treated with percutaneous cannulated screw fixation according to the 'three point principle'. These patients were reviewed retrospectively, paying special attention to mechanical failure. Thirty-five fractures healed in a good position. Four fractures (10 per cent) showed signs of recurrent instability, resulting in non-union in two and malunion in one. In all four cases of mechanical failure faults in the operative technique or indication could be established. We conclude that percutaneous cannulated screw fixation is a promising method. However, the right indication and a precise operating technique are important.

Adult↗
PubMed1995

[Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period].

We evaluated changes in dementia rating scale scores in the revised version of Hasegawa's dementia scale (HDS-R), and rated dementia, 2 days before and 7 days after surgery in the elderly patients with femoral neck fracture. The 50 patients examined ranged in age from 70 years to 101 years. A perfect score in the HDS-R is 30 points, and a score below 20 points strongly suggests dementia. The results were as follows. In septuagenarian and octogenarian patients, the scale score was higher after surgery than the value before the surgery. Although the preoperative and postoperative scores of the patients who had been under epidural anesthesia were not significantly different, the score of patients who had been under general anesthesia was higher in the postoperative period than in the preoperative period. In octogenarian patients, there was a negative correlation between "postoperative score minus preoperative score" and "the number of the days from suffering fracture to surgery". These results showed that general anesthesia is more advantageous than epidural anesthesia from the viewpoint of the intellectual faculty in septuagenarian and octogenarian patients with femoral neck fracture, and it is within the bounds of possibility that the intellectual faculty may decline if an octogenarian patient is operated after a long delay from the occurrence of fracture. To prevent this decline, patients must be operated on as soon as possible.

Age Factors↗
PubMed1975

[Can we reduce complications of treatment of femoral neck fractures with better stabilisation of the osteosynthesis? Results of a compression-osteosynthesis (author's transl)].

The results of a compression-osteosynthesis of the fracture of the femoral neck on the evidence of 172 cases realizing the principle of a drawing-screw-compression of the AO have been reported. The results will be compared with the data of collected statistics of other types of nailing of the femoral neck and it will be established, that the better stabilisation of fractur will be manifest in the results too and will be realised in the decrease of complications (slipping of the nail, redislocation, pseudarthrosis, avascular necrosis of the head).

Aged↗
PubMed1999

[Femoral neck fracture complicating algodystrophy in pregnancy].

BACKGROUND: Sympathetic reflex dystrophy is an uncommon cause of pelvic pain not to be overlooked in pregnant women. CASE REPORT: At 8 months pregnancy, a 27-year-old woman complained of invalidating pain of the left hip. Magnetic resonance imaging of the pelvis performed the day after delivery evidenced a non-displaced fracture of the femoral neck and a typical aspect of sympathetic reflex dystrophy. DISCUSSION: The true frequency of sympathetic reflex dystrophy during pregnancy is probably underestimated. Approximately one hundred cases have been reported. The hip joint is involved in 9 out of 10 cases. Such localizations are uncommon outside pregnancy, accounting for 14 to 17% of all cases.

Adult↗
PubMed1992

[Management of femoral neck fractures with the spongiosa screw and the dynamic hip screw].

Between 1983 and 1987 419 patients with femoral neck fractures were operated on at the University Clinics of Graz. In 120 patients we could preserve the head of the femur doing an internal fixation with cancellous bone screws or DHS. 68 of them we personally could control with a mean follow up of 45.2 months. The most important complications were the necrosis of the head which were observed in 19.1% of our patients and the non union which occurred in 5.8% but not all these patients required reoperation.

Adolescent↗
PubMed2002

Conservative treatment of Garden stage I femoral neck fracture in elderly patients.

We reviewed 38 patients aged 65 years and older with fresh Garden stage I femoral neck fractures treated nonsurgically to determine factors that influence fracture union. The mean follow-up period was 20 (range 6-86) months. Twenty-three (61%) fractures united within 6 months after injury, while 15 (39%) failed to unite. The percentage of united fractures was considerably higher (p < 0.01) in patients who began bed-to-wheelchair transfer training 14 days or later after injury than in those who began training within 13 days. The incidence of union was considerably higher (p < 0.05) in patients who began ambulation 20 days or later after injury than in those who began within 19 days. There was no statistical difference in the amount of valgus or retroversion of the femoral head between patients whose fractures united and those whose fractures did not. Patients without severe dementia regained the ability to walk significantly more frequently than did patients with severe dementia (p < 0.05).

Aged↗
PubMed1988

Femoral neck fractures in an elderly white South African population.

In a retrospective survey of 184 patients treated for fracture of the femoral neck follow-up was obtained in 170; all were over 50 years of age and the male to female ratio was 1:5. The 12-month mortality rate was 20% and only 50% walked normally. Displaced fractures showed a higher morbidity and mortality rate than non-displaced fractures. Prognostic factors which may assist selection of the optimum treatment for individual patients are identified.

Aged↗