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PubMedDate not supplied

[An analysis of surgical treatment methods in femoral neck fractures based on a patent information search].

Patent inventive discoveries in the USSR over the period 1949-1989 are analyzed together with the world patent discoveries, inventions, designs (Ukraine since 1989 included) over the period 1978-1998, which are divided into several groups different in principle, criteria of analysis are singled out, new notions of "cruel", dosage, dynamic compression are determined. By making use of principles of biological low-invasive metallo-osteosynthesis and new notions of "cruel", dosage, and dynamic compression optimal options were found for fixation of fractures of the femoral neck: low-traumatic nail set in the neck at an angle of 130 degrees fit with a small-sized diaphyseal put-in lamina and a local stimulation of union or spongiosa for the neck of the femur screw with an attachment preventing caput femoris rotation, and a springy element combined with a small-sized diaphyseal put-in lamina (that is, a modified system of the dynamic screw for the neck of the femur).

Bone Nails↗
PubMed2004

Femoral neck fracture in an arthrodesed hip treated by a supracondylar intramedullary locked nail.

We describe a case of a femoral neck fracture occurring 51 years after a hip arthrodesis. This rare lesion in an obese woman was treated with a straight supracondylar nail with proximal and distal locking inserted retrograde from the subtrochanteric area into the ileum. Full weight bearing was achieved within 1 week postoperatively, and union was present 3 months following the operation.

Aged↗
PubMed1985

Femoral neck fractures in skeletally mature patients, fifty years old or less.

We studied the cases of thirty-two skeletally mature patients, fifty years old or less, who had a fracture of the femoral neck. In all patients with a stage-1 or 2 fracture, the fracture healed without osteonecrosis. Among the stage-3 and 4 fractures, the rate of non-union was 5.5 per cent and that of osteonecrosis, 33 per cent (3 and 18.8 per cent, respectively, for the whole group). Three patients with osteonecrosis required revision to arthroplasty at six, sixty-eight, and ninety-nine months. Three others had good function of the hip at forty-eight, ninety-six, and 129 months despite the development of osteonecrosis. Treatment of these fractures yielded very good results over-all, and even the occurrence of osteonecrosis did not necessarily cause an unsatisfactory result.

Adolescent↗
PubMed1998

Serum albumin and deep infection in femoral neck fractures. A study of 437 cases followed for one year.

Four hundred and thirty-seven patients with femoral neck fractures were studied to determine the value of serum albumin estimations on admission. Serum albumin is a good predictor of mortality, and patients with low levels should be given additional nutritional support. We found that the serum albumin level is not useful in predicting deep wound infection. The infection rate of 3% does not justify the use of antibiotic prophylaxis in general.

Aged↗
PubMed1996

[Cement-free management of femoral neck fractures in elderly patients with poor cardiopulmonary prognosis].

The use of acrylic bone cement in the treatment of femoral neck fractures with prosthetic implants is associated with a high complication rate in patients suffering from cardiopulmonary problems. This type of patient can be treated with a cementless hip prosthesis without the danger of a cardiovascular depression occurring. The cementless operating technique produces a good primary stability even where bone quality is poor and, therefore, immediate post-operative limitations on weight bearing are not required.

Acrylic Resins↗
PubMed1991

[Femoral head preserving therapy in medial femoral neck fractures. A clinical study of the effects of treatment method on the outcome].

The main problem with fractures of the femoral neck is the high incidence of avascular necrosis and non-union. While the rate of pseudarthroses has been lowered by treatment with stable compression screws, no effect of this technique on the incidence of head necrosis is evident. The reasons for this are rupture of vessels, wide dislocation of fragments and diminution of blood supply owing to intracapsular hematoma. Since 1982 we have been using a defined indications and therapy schedule for these fractures, which is based on the main principle of open operative treatment in younger patients. This procedure is the only one that makes accurate reduction and stable internal fixation of fragments possible. With the opening of the capsule and evacuation of the hematoma pressure on the blood vessels is relieved. The analysis of data recorded in 81 patients treated with open reduction and stable internal fixation revealed that poor functional results and avascular necrosis occur especially in fractures of Garden's stages III and IV that are operated on longer than 6 h after the trauma is sustained. Therefore, the operation should be performed as soon as possible as an emergency procedure to reduce the likelihood of such severe complications.

Femoral Neck Fractures↗
PubMed2000

Is there still an indication for operative treatment of femoral neck fractures with a ceramic hemiprosthesis? Four-year results.

From 1985 to 1995, 417 patients with dislocated medial femoral neck fractures (Garden III-IV) were treated with hemiarthroplasty using a Biolox ceramic head. The average patient age at the time of operation was 81.5 years. A total of 140 survivors was available for follow-up examination with a mean prosthesis longevity of 55.8 months. The Harris hip score recorded a mean of 70.6 points. At the time of follow up, 5 patients had severe hip pain, and in 8 the roentgenographic examination revealed protrusio acetabuli. Five of these 8 patients underwent revision surgery for replacement of the cup, leaving the stem in situ.

Aged↗
PubMed1996

Machine learning in prognosis of the femoral neck fracture recovery.

We compare the performance of several machine learning algorithms in the problem of prognostics of the femoral neck fracture recovery: the K-nearest neighbours algorithm, the semi-naive Bayesian classifier, backpropagation with weight elimination learning of the multilayered neural networks, the LFC (lookahead feature construction) algorithm, and the Assistant-I and Assistant-R algorithms for top down induction of decision trees using information gain and RELIEFF as search heuristics, respectively. We compare the prognostic accuracy and the explanation ability of different classifiers. Among the different algorithms the semi-naive Bayesian classifier and Assistant-R seem to be the most appropriate. We analyze the combination of decisions of several classifiers for solving prediction problems and show that the combined classifier improves both performance and the explanation ability.

Algorithms↗
PubMed1983

Moore prosthesis in the treatment of fresh femoral neck fractures. A critical review with special attention to secondary acetabular degeneration.

A consecutive series of 106 patients with displaced femoral neck fractures was treated initially with Moore prostheses. The patients' mean age was 82.5 years (range, 67-91). At follow-up after two years, 71 patients attended. Thirty-seven per cent of these were in need of a conversion of their one-piece device to a total hip replacement on account of hip pain. When only active patients living in their own homes were considered, 55 per cent were found to need total hip replacements. The main reason for the development of hip pain was acetabular derangement. It was concluded that active patients, disregarding their age, should not be treated with one piece prostheses of their fractures could be satisfactorily reduced and pinned. If this cannot be accomplished, a primary total hip replacement may be considered.

Acetabulum↗
PubMed2003

Femoral neck fractures in older patients: indication for osteosynthesis.

In almost all the patients over 65 years of age with intracapsular femoral neck fractures who we treated over a 2-year period, we used osteosynthesis with Ace 6.5-mm cannulated cancellous screws. We then followed them for at least 24 months. Each of the seven nondisplaced fractures healed. Of the 20 displaced fractures, 14 were rated as healed, 5 as failures, and 1 as a late segmental collapse. Among the 14 displaced fractures with an operative delay of 1 day, 12 healed, whereas only 2 of the 6 fractures with an operative delay of 2 days or more did so. Of the 12 typical fractures (with a medial spike in the head fragment), 10 healed, as did 4 of the 8 crescent or mixed-type fractures. The treatment of choice for nondisplaced fractures is osteosynthesis. Displaced fractures that occur on the day of operation or the day before should be treated with osteosynthesis if they are the typical type. The rest of the displaced fractures should be considered candidates for primary prosthetic replacement.

Aged↗
PubMedDate not supplied

[Osteosynthesis of the femoral neck fractures using the original device].

At the centre of traumatology, the Central District Clinical Hospital N 12 of Kiev, the authors have conducted investigations in order that on the basis of clinical and roentgenologic findings they might assess both early and long-term results of osteosynthesis of the femoral neck fractures with the aid of the elaborated device made of titanium. The studies were made in 43 patients aged 30 to 70 years over the period 1997-2000. Complications were recorded in 9.5 percent of cases. Osteosynthesis of the femoral neck fractures by making use of the elaborated device will, we believe, come to be efficiently used by traumatologists.

Adult↗
PubMed1978

[Femoral neck fracture treated by head arthroplasty: factors of life prognosis. 477 cases (author's transl)].

477 cases of femoral head arthroplasty for fresh femoral neck fractures were reviewed to study the various factors modifying life prognosis during the first six months (age, associated disorders, type of prothesis, postoperative complications). Certain of these factors were found to affect prognosis unfavorably: bad general health, alcoholism, psychiatric or neoplasic disease, diabetes, and also, to a less degree, senility, neurologic and sensorial disturbances, cardiac deficiency. A rate table makes it possible to make a prognosis on the basis of these different factors.

Age Factors↗
PubMed1982

Treatment of femoral neck fractures with the sliding compression screw.

Twenty-nine patients with intracapsular fractures of the femur were treated with a sliding compression screw. The overall incidence of unsatisfactory results was 48%. In the combined group of Garden III-type and Garden IV-type fractures, 58% had unsatisfactory results. The Garden IV type fractures, considered separately, had 89% unacceptable results. The most significant factors associated with an unsatisfactory result were: (1) poor reduction; (2) poor alignment or depth of the screw; and (3) the use of the long threaded lag screw. Inability to control the proximal fragment during the procedure made it difficult to maintain satisfactory reduction and may have contributed to avascular necrosis in seven of the 29 hips. Displaced fractures of the femoral neck are difficult to reduce and transfix. The sliding compression screw did not compensate for a technically poor reduction or unsatisfactory surgical placement of the device.

Bone Screws↗
PubMed1997

Fixation of displaced femoral neck fractures with a sliding screw plate and a cancellous screw or two Olmed screws. A prospective, randomized study of 225 elderly patients with a 3-year follow-up.

BACKGROUND AND AIMS: To analyse the importance of fixation method in displaced femoral neck fractures and to identify factors predictive of failure of the fixation. MATERIAL AND METHODS: Two hundred and twenty-five patients were included in a prospective, randomised study and operated on for a displaced, subcapital fracture of the femoral neck with either a sliding screw plate and a parallel cancellous screw (SSP), or two Olmed screws. The median follow-up time was 39 (22-51) months, excluding reoperated and dead patients. RESULTS AND CONCLUSIONS: Operation and anaesthesia time was considerably longer for the SSP system. The risk of failure was significantly increased (odds ratio 6.6) for patients operated with SSP outside ordinary working time. Poor reduction was recognized as a risk factor of failure for both types of fixation (odds ratio 3.1). The rate of reoperation within 3 months was 18.5% in the SSP group and 9.4% in the Olmed screw group. The rates of nonunion were 6.2% and 8.5%, respectively. The rates of late segmental collapse, 18.0% and 19.5% of all united fractures, respectively, decreased with increasing age (odds ratio 0.88). Salvage operations (replacement with bipolar or total hip prosthesis) were made in 30.6% and 26.5% of the cases, and the total rates of reoperation were 37.0% and 29.1%, respectively. We conclude that both treatment methods result in an unacceptably high rate of failures and reoperations, and that alternative treatment, prosthesis replacement, should be considered in selected cases.

Aged↗
PubMed1984

Charnley low-friction arthroplasty for the treatment of hips with late complications of femoral neck fractures.

Two hundred five Charnley low-friction arthroplasties (LFA) were performed in 205 patients for late complications of femoral neck fractures. LFA was an excellent procedure for relieving pain and restoring function with a good range of movement. The deep infection rate was 3.9%. A detailed analysis of the patients with infection showed a high incidence of previous superficial wound infection or positive bacteriologic culture swabs obtained from the wound at the time of LFA.

Aged↗
PubMedDate not supplied

Pugh nail fixation of displaced femoral neck fractures. A long term follow-up.

Of 695 intracapsular hip fractures with known end results, 80 per cent occurred in women whose average age was 71 years; of 101 consecutive undisplaced intracapsular fractures reported up to 1959, 81 were treated by internal fixation and 20 nonoperatively and all united but 11 per cent developed necrosis. From 1937 to 1959, displaced intracapsular fractures at St. Luke's Hospital were generally treated by closed reduction and Smith-Petersen nail fixation. From 1948 to 1952, 22 per cent of these fractures failed to unite, but from 1952 to 1959, 44 per cent failed to unite. Many of the failures were due to the Smith-Petersen nail backing out. These poor results inspired another device which might provide better fixation and prompted the use of the telescoping Pugh nail. From 1955 to 1971, the telescoping Pugh nail was used in 256 displaced intracapsular fractures with known end results. Ninety per cent united, and avascular necrosis was seen in 17 per cent of the united fractures. Since many of the patients with avascular necrosis has no pain, they were considered satisfactory results. Subtracting these 17 per cent of 256 patients with displaced intracapsular fractures of the femoral neck may be evaluated as examples of satisfactory results with the Pugh nail.

Aged↗