SEARCH · PubMed Health

Results for “FEMORAL NECK FRACTURES”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed1992

Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children.

Seventeen transcervical/basal femoral neck fractures in children were treated by free fibular graft and cancellous lag screw. Two cases were failures of a previous surgery, and 15 had been untreated for 3 weeks or more. Four cases had radiological evidence of avascular necrosis of the head and one of the neck preoperatively; five cases had neck resorption. At an average of 48.1 months postsurgery all fractures had united and there was only one new case of avascular necrosis. Four cases had coxa vara, and four cases had premature epiphyseal closure. There were 13 good, three fair, and one poor result(s) using Ratliff's criteria. We recommend this procedure in cases with delayed initial appearance or failed previous surgery. Complications of the procedure such as long screw/graft and fibular fracture are preventable. The incidence of coxa vara in cases with neck resorption may be reduced by adding subtrochanteric osteotomy to the procedure.

Adolescent↗

PubMed1984

Pre-operative and postoperative scintimetry after femoral neck fracture.

In 22 patients with femoral neck fractures 99mTc-MDP scintimetry was performed before operation and again shortly after operation; in 17 of these patients the investigation was repeated after four months. Six patients with increased uptake in the femoral head before operation and eight with decreased uptake had similar results at the first postoperative investigation. Of eight patients with an intermediate uptake before operation, two showed increased and six decreased femoral head uptake after operation. It is concluded that for the patients in the group with intermediate femoral head uptake before operation, the operative procedure probably influenced the postoperative blood supply of the femoral head.

Adult↗

PubMed1991

Appropriate management of femoral neck fractures in Nepal.

The management of femoral neck fractures in the Third World has always been a problem. Its management in Nepal reflects the level of available treatments for other orthopaedic conditions, as well as for medical care in general. The most successful methods of fracture treatment have remained the simple ones, consistent with the available resources. Adherence to this philosophy of management, carried out with attention to the needs of the people, reduces the incidence of iatrogenic complications. Six years of experience in the management of femoral neck fractures by traction, plaster, McMurray's osteotomy, modified Girdlestone's excision arthroplasty and Austin Moore prosthetic replacement have been reviewed, along with the relevant literature. Non-operative management has been found to be the most satisfactory method of treatment when related to the overall medical resources in Nepal.

Adult↗

PubMed1976

[Factors influencing the results in the treatment of patients with femoral neck fractures (author's transl)].

The results of 213 consecutive operatively treated patients with fractures of the femoral neck were evaluated. Especially the effects of improved operative technique, careful pre- and postoperative care and intensified rehabilitation were observed. The series consisted of 151 women and 62 men, 111 femoral neck fractures and 102 trochanteric fractures. Nailing was performed on 54 femoral neck fracture patients and endoprothesis operation on 57 patients. No statistically significant differences were proved when the two consecutive two years series were compared with one another concerning the nailing results and the frequence of thrombosis and infection. However, by means of early weight-bearing and improved pre- and postoperative care the 6 months mortality decreased statistically significantly (chi2 = 6.58, p less than 0.05).

Aged↗

PubMed1993

[The dynamic hip screw (DHS) in femoral neck fractures].

Out of 224 patients with femoral neck fractures, 40 patients have been treated by ORIF with the dynamic hip screw, whereas 27 have been fixed by large cancellous bone screws and 148 femoral heads were replaced by a prosthesis. The ORIF with dynamic hip screw has been performed as an emergency intervention within 6.2 hours after accident. Good general condition without contraindication against an emergency operation as well as a biological age below 65 years and no pre-existing coxarthrosis are mandatory for the indication for open rigid internal fixation. Personal follow-up of 37 patients with x-ray documentation after at least 18 months (mean 35.4 months) showed complete rehabilitation in 31 patients and 4 femoral head necrosis (10.8%). We conclude that these good results are due to the short interval between accident and operation as well as to the evacuation of the intraarticular hematoma together with stable internal fixation and functional rehabilitation. Due to our good results we prefer long cancellous bone screws for the operative fixation of femoral neck fractures in younger patients, whereas in the older group the dynamic hip screw is preferred.

Adolescent↗

PubMed1988

Austin Moore replacement hemiarthroplasty in femoral neck fractures of the elderly.

162 femoral neck fractures were treated with Moore endoprostheses. Primary mortality was eight per cent, and after an average of seven years postoperatively 25 per cent of the patients were alive. Complications were recorded in 22 cases. Nine of the patients underwent a further operation. Thirty-one patients participated in a clinical follow-up study and eight patients answered a subjective questionnaire. Two hips showed excellent, eight good, ten fair and twenty-two hips poor results. The use of hemiendoprosthetic replacement should be reserved for displaced fractures and for patients with a short life expectancy. In cases of even initial osteoarthritis primary total hip arthroplasty should be performed if an endoprosthetic replacement is considered.

Aged↗

PubMed1996

Pain due to bone insufficiency as a symptom heralding femoral neck fracture.

Although falls are a major factor in the occurrence of femoral neck fractures, their type and frequency have not been studied in detail. A few case-reports have demonstrated that bone insufficiency can lead to femoral neck fracture and that some falls occur as a result of acute pain preceding the fracture. Estimations of the proportion of femoral neck fractures due to bone insufficiency have ranged from 3% to 24%. We conducted a clinical study of 51 patients with recent femoral neck fractures (46 women and 5 men; mean age, 80.6 +/- 9.3 years). Of the 38 patients who fell from the standing position, three (5.9%) experienced acute pain before the fall. Five patients (9.8%) reported trivial trauma and eight (15.7%) no trauma. Twenty-three patients (45.5%) had hip pain during the weeks preceding the fracture; in 20 cases, the pain was located only to the hip that was subsequently fractured. Features associated with spontaneous fracture were pain during the preceding weeks (7/8; p<0.01), gradually worsening pain (6/7; p<0.02), pain in the inguinal or crural area (6/7), and recent onset of pain (< 3 months) (5/7). We believe that the incidence of bond insufficiency as a cause of femoral neck fracture has been substantially underestimated as a result of diagnostic difficulties and of the usually moderate severity of prefracture pain. Improved knowledge of prefracture symptoms provided by a prospective study may allow appropriate treatment by elimination of weight-bearing, avoiding a substantial number of femoral neck fractures.

Absorptiometry, Photon↗

PubMed1993

[An application of multiple logistic regression analysis to an outcome study on surgery for patients with femoral neck fracture].

Sixty five patients with femoral neck fracture were examined to find any risk factor for their postoperative complications. Here, postoperative complications included cardiac catastrophe, pulmonary embolism, central nervous system accident, and respiratory failure requiring mechanical ventilation during the period of one week after operation. Multiple logistic regression analysis was used to predict these factors. Explanatory variables were selected based on the clinical judgement. Those variable are age, sex, preoperative underlying cardiac disease, preoperative underlying respiratory complications, the use of cement for the procedure, and anesthetic technique. The analysis revealed that the sex was the only variable that was considered significant based on the P value less than 0.05. However, multi-colinearity between variables was suspected to exist based on the correlation matrix analysis which may indicate that the factor is not, in fact, significant. In short, further study will be required to find any significant variables or risk factors to predict the outcome of untoward events.

Aged↗

PubMed1995

Blood transfusion requirements in femoral neck fractures.

Fractures of the femoral neck are common, and their incidence seems likely to increase. A prospective study in 1991 of 80 patients with such fractures suggested that not all need to be cross-matched preoperatively, a finding supported by the existing literature. At the same time, a survey of transfusion protocols in hospitals throughout the country suggested that much blood was being wasted daily in unnecessary cross-matching. This survey was repeated in 1995, and little appears to have changed. The implications of this are discussed.

Aged↗

PubMed1980

Indications for open reduction of femoral neck fractures.

The Garden alignment index is useful for femoral neck fractures in the aged and defines an acceptable reduction as 155 degrees-180 degrees in both views. The quality of films available in the operating room may not permit accurate measurements of the index. As a substitute, anterior and medial cortical displacement of more than 2 mm may be used as a measure of unsatisfactory reduction. Because malreduction is associated with a high incidence of nonunion and avascular necrosis, inability to achieve acceptable reduction of an adult femoral neck fracture is an indication for open reduction. Since posterior communication is also associated with a high rate of healing complications, it is another indication for open reduction. Bone grafting and careful reshaping of the distal fracture fragment at open reduction can provide stability to promote healing. The incidence of complication of femoral neck fracture is especially high in young adults and children. Anatomic reduction is essential in these age groups to minimize nonunion and avascular necrosis. Primary open reduction is advisable for displaced femoral neck fractures in patients less than 40 years of age if a single gentle closed manipulation fails to provide anatomic reduction.

Adult↗

PubMed2003

Subtrochanteric fracture after cannulated screw fixation of femoral neck fractures: a report of four cases.

Subtrochanteric fractures after screw or pin fixation of femoral neck fractures are a recognized complication. No literature is available on this complication after fixation using the recently popularized cannulated screws. We present our experience in treating four of these complications. The common denominator for all four patients seemed to be an entry point in the lateral cortex below the level of the most inferior edge of the lesser trochanter.

Aged↗

PubMed1987

[Experimental study on the mechanism of femoral neck fractures].

To investigate the mechanism of femoral neck fracture, experimental studies were conducted on 48 femurs from 24 cadavers and the relationship between the type of fracture and loss of bone strength due to osteoporosis was investigated. The following results were obtained. 1) Intracapsular fracture was produced with the loading parallel to the axis of the femoral neck and with no applied rotatory force. 2) Among trochanteric fractures, peritrochanteric fracture was produced with rotatory force applied to the femoral head, while intertrochanteric fracture was produced with the loading perpendicular to the femoral shaft. 3) The fracture strength along the seven loading axes on the femoral head decreased with the progress of osteoporosis to the same degree in all directions. The fracture strength on Singh index Grade II, III examples decreased to approximately 1/3-1/4 of Grade VI examples. 4) The type of fracture macroscopically depended upon the direction of the loading, and had no correlation with osteoporosis.

Adult↗

PubMed2001

[Minimally invasive screw fixation of the intracapsular femoral neck fracture in elderly patients].

INTRODUCTION: Increasing life expectancy is associated with an increase of geriatric fractures such as intracapsular femoral neck fractures. Their treatment by arthroplasty imposes a significant burden on our health care system. METHODS: In an open clinical study we investigated the complication rate of a less expensive and less invasive, femoral head saving operative procedure. Between June 1997 and June 2000, 205 intracapsular femoral neck fractures of elderly patients (mean age 78.1 +/- 11.8 years) were fixed with cannulated screws. RESULTS: Seventy-seven percent were displaced fractures and 15.6% were impacted Garden I fractures. Reoperation after internal fixation occurred in 38 patients. The most frequent cause of reoperation was secondary arthroplasty due to redisplacement (14x), femoral head necrosis (10x) and non-union (7x). Implant removal (4x), wound hematoma (1x) and femoral head penetration by screws (2x) were other causes for reoperation. CONCLUSION: Less invasive cannulated screw fixation of intracapsular femoral neck fractures should be considered as a treatment option, because it is a smaller and less expensive operation than prosthetic replacement. Adequate reduction and screw placement, however, are a prerequisite for successful outcome.

Aged↗

PubMed2001

Spontaneous femoral neck fracture complicating a healed subtrochanteric fracture--a case report.

A rare case of spontaneous femoral neck fracture complicating a healed subtrochanteric fracture was encountered in an 85-year-old female. The subtrochanteric fracture was caused by a minor trauma with no other combined injury. Patient received close reduction and internal fixation two days later and the fracture healed in three months. Six months after operation, spontaneous ispilateral femoral neck fracture occurred without trauma. Although there were some reports about subcapital fracture or femur neck fracture complication after operation, this is the first case of spontaneous femoral neck fracture after healed subtrochanteric fracture which was treated with a 95 degrees dynamic condylar screw (DCS) and side plate previously without technical error.

Aged↗

PubMed1979

Femoral neck fractures following surface replacement.

A femoral neck fracture following surface replacement of the hip has been studied and five potential causes of failure were noted. These consisted of; removal of a hip nail during surgery, use of a too small femoral cup, initial reaming in varus, notching of the femoral neck, and failure to completely seat the cup.

Female↗

PubMed1978

[Early results of the operated patients with a femoral neck fracture. Experiences with the AO techniques in the Central Hospital of Central Finland in 1972--75 (author's transl)].

The results of 223 patients with fractures of the femoral neck treated by AO osteosynthes were evaluated. The series consisted of 140 women and 83 men, 114 femoral neck fractures and 109 trachanteric fractures. One year after the operation the nailing results were poor in 22.9 per cent of the femoral neck fractures and in 2.7 per cent of the trochanteric fractures. The reasons of the poor results were mainly the perforation of the nail. Pseudoarthrosis were founded in 3 cases and in one case the AO nail was broken. The mortality after 2 weeks was 3.1 per cent, after one month 6.3 per cent, after 6 months 15.7 per cent and after 12 months 20.6 per cent. Infection and thrombosis were founded both in 3.1 per cent.

Aged↗

PubMed1991

[Early complications in treatment of femoral neck fractures. Experiences with Olmed screws].

Postoperative secondary displacement of displaced femoral neck fractures is a major problem in the treatment of this fracture. In a study of 232 femoral neck fractures operated at the Department of Surgery, Harstad Hospital and at the Departments of Surgery and Orthopaedics, Tromsø University Hospital, the reduction was lost in 12% of the displaced fractures within three months. The fractures were fixated with two 6 mm screws (Olmed). The deep infection rate was 3.4%. There were significant differences between the hospitals. The rate of redisplacement was 5% at Harstad Hospital and 29% at the Tromsø University Hospital (p less than 0.001), the rate of deep infection was 1.8% versus 7.5% (p less than 0.05). Early complications are caused by poor quality of reduction and incorrect positioning of the screws. The surgeons' lack of experience in treating these fractures gives rise to a high rate of complications. The main reason for the low rate of complications in the material from Harstad Hospital is continuous and prospective quality control of femoral neck fractures. Such continuous feedback, and an interest intreating these fractures among the surgical staff, obviously improves the results. When the Olmed method of fixation is used correctly the rate of early complications is small.

Adult↗

PubMed1989

[A rare case of simultaneous bilateral femoral neck fracture].

In connection with a simultaneous bilateral femoral neck fracture in old age author underlines its rare occurrence, even in the international literature. He thinks the conservation of the femoral head even in old age especially significant, in the choice of the operation however the mental state of the elderly must also be taken into consideration. In bilateral femoral neck fracture, on one side by all means, a hemiarthroplasty of sure weight bearing stability is thought to be necessary.

Accidental Falls↗