PubMed Health⌕ Search

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 19 recordsLinked to original sources
PubMed1982

[Radiographical and pathohistological study of the femoral neck fractures].

Femoral neck fractures are of great interest for challenging several problems to indicate surgical procedures. Even though ages and general or local conditions of the patient, and types of fracture or some other influencing factors are sufficiently taken into consideration, it is very difficult to foresee the fate of femoral head on the radiogram at the time of injury. This viability of fractured femoral head is the most important factor to choose the method of treatment, but no adequate method of assessing the viability has been established. One hundred and twelve femoral heads removed in the course of endo-prosthetic replacement were examined radiologically and histopathologically to study the factors influencing to the fate of fractured femoral heads. Histological findings of the femoral heads, in particular the extent of necrotic or revascuralized areas on the decalcified section stained with H-E, were compared with radiological findings such as the size or shape of the femoral head, the fracture line, the extent of displacement and osteoporosis or Singh's grade. Several factors which may influence the viability of the fractured femoral head have become clear. The site and direction of fracture line, extent of displacement and destruction of femoral head were thought to be important factors. Medial type of femoral neck fractures could be classified into four groups from a result of this study. They are less displaced, transcervical, crescent shape and severe displaced type. The first two may have a tendency to good revascuralization, and the last two groups to necrosis of the fractured head. This clinical classification is thought to be useful in the treatment of this fracture.

Aged↗
PubMed2004

A new software for prediction of femoral neck fractures.

Femoral neck fractures are an important clinical, social and economic problem. Even if many different attempts have been carried out to improve the accuracy predicting the fracture risk, it was demonstrated in retrospective studies that the standard clinical protocol achieves an accuracy of about 65%. A new procedure was developed including for the prediction not only bone mineral density but also geometric and femoral strength information and achieving an accuracy of about 80% in a previous retrospective study. Aim of the present work was to re-engineer research-based procedures and develop a real-time software for the prediction of the risk for femoral fracture. The result was efficient, repeatable and easy to use software for the evaluation of the femoral neck fracture risk to be inserted in the daily clinical practice providing a useful tool for the improvement of fracture prediction.

Bone Density↗
PubMed2002

Femoral neck fractures.

Femoral neck fractures in the geriatric patient continue to represent a therapeutic challenge. Despite advances in surgical techniques and medical care, the risk of nonunion and osteonecrosis after fixation have not changed appreciably in the last 50 years. Considerable debate continues to occur with respect to the relative merits of internal fixation versus arthroplasty. The relative benefits and complications of unipolar and bipolar hemiarthroplasty, as well as total hip replacement, continue to be poorly understood. The next decade will bring advances in the prevention and treatment of osteoporosis that may finally decrease the incidence of these fractures. Advances in the use of bone graft substitutes may finally improve the outcome of internal fixation.

Accidental Falls↗
PubMed1995

[Classification, therapy and complications of pediatric femoral neck fractures].

Femoral neck fractures in children are rare injuries (less than 1 percent). The fracture pattern consists of transepiphyseal, transcervical, cervicotrochanteric and intertrochanteric fractures. Main problems with this type of injury are avascular necrosis, varus deformity, nonunion and premature epiphyseal closure. Varus and nonunion are affected by the treatment, vascular compromise with necrosis or growth problems are not related to therapy and hardly to control. Primary dislocated fractures are emergencies and need immediate operative management. Stabilization is achieved with K-wires or cancellous screws dependent on the child's age. In children below 3 years a pelvis cast is necessary post-operatively. Partial weight bearing is started 6 weeks post trauma and is rapidly increased to full weight bearing. One year post-operation the metal is removed, K-wires directly after bony healing.

Adolescent↗
PubMed2005

Delayed presentation of ipsilateral femoral neck fractures in diaphyseal femur fractures.

Femoral neck fractures with delayed presentation following ipsilateral femoral diaphyseal fracture stabilization have been described as clandestine, attributed to missed diagnosis, or related to surgical technique. Clandestine fractures are present from time of injury but not detectable. The authors hypothesize that femoral neck fractures with delayed presentation can be clandestine, missed, or caused by surgical technique. A retrospective study and a comprehensive literature review are presented to determine the true incidence and etiology of these fractures.

Diaphyses↗
PubMed1996

The effect of femoral neck fractures on femoral head blood flow.

Treatment of femoral neck fractures remains a significant clinical challenge. The choice between femoral head replacement and internal fixation must take into account the patient's age, activity level, degree of osteoporosis, and medical condition. If open reduction and internal fixation is chosen, an understanding of the vascular pathophysiology of femoral neck fractures is helpful to insure the best clinical result. Osteonecrosis of the femoral head and non-union of the femoral neck fracture are the two most common complications following fixation of a femoral neck fracture. The vascular damage from the fracture itself significantly reduces femoral head perfusion. Therefore, a careful and anatomic (or slightly valgus) reduction, followed by rigid fixation with three pins, three screws, or a hip screw construct, is advised. There is experimental and clinical evidence that "emergent" open reduction and internal fixation and capsulotomy may lessen the vascular insult from the femoral neck fracture itself.

Adult↗
PubMed1998

Contrast enhanced magnetic resonance imaging for femoral neck fracture.

Femoral head perfusion was evaluated in 29 patients after acute femoral neck fracture using contrast enhanced fat saturation magnetic resonance imaging. The patients were followed up with T1 and T2 weighted spin echo magnetic resonance imaging without fat saturation, which is suitable in detecting avascular necrosis. The mean interval from injury to the initial contrast enhanced fat saturation magnetic resonance imaging was 24.5 hours. The mean age at the time of injury was 69 years, and the mean followup was 26.9 months. Three distinct patterns of femoral head enhancement were recognized in the acute phase after fracture. When the whole femoral head was well enhanced (Type 3, n = 11), no avascular necrosis developed. In contrast, when the head showed no enhancement (Type 1, n = 6), avascular necrosis developed in all patients. In patients with partial enhancement (Type 2, n = 12), avascular necrosis developed in five patients. These data showed the current method provided an accurate prediction of the development of avascular necrosis in the patients with Type 1 and Type 3 enhancement. However, overall predictive value was 59% (17 of 29 patients) because of the uncertainty in the patients with partial enhancement (Type 2), and additional study is needed for this method to become routine in clinical use.

Adolescent↗
PubMed1993

Femoral head perfusion in patients with femoral neck fracture and femoral head necrosis.

Femoral head perfusion in adults was studied by superselective i.a. DSA in 35 normal subjects, in 9 patients with medial femoral neck fracture preoperatively, and in 36 patients with femoral head necrosis before bone grafting, and as therapeutic control after grafting. All patients with femoral neck fracture showed an interruption of the proximal nutrient branches. In 93% of the cases with femoral head necrosis, these branches were rarefied or the medial circumflex femoral artery was interrupted. Postoperative DSA after pedicled pelvic bone graft revealed a regularly perfused graft in 82%. Superselective i.a. DSA is a valuable procedure for the therapeutic decision in selected patients with femoral neck fracture as well as before pedicled pelvic bone grafting and as therapeutic control after grafting.

Adult↗
PubMed1983

A radiographic five-year follow-up of femoral neck fractures.

Forty femoral neck fractures were followed for 5 years in a prospective clinical, roentgenographic and scintimetric investigation. Thirteen cases had uncomplicated healing, 22 necrosis and five non-union. The diagnostic value of radiographic changes was analysed with reference to development of necrosis of the femoral head or non-union. Sclerosis of the femoral head, and compression and displacement of the fracture were compatible with eventual healing and clinical recovery. Subchondral fracture and collapse of the load-bearing surface, diagnostic for necrosis, were observed in only 7 of 22 cases at 1 year and as late as 3-5 years in three cases. By contrast, four out of five non-union cases were established radiographically within 1 year. Patients needing an arthroplasty after fracture of the femoral neck should be identified on clinical grounds after early radionuclide scintimetry. Waiting for radiographic documentation of necrosis in cases with pain will increase the risk for physical and social impairment associated with poor function of the hip.

Adult↗
PubMed1985

The longest delay between femoral neck fracture and femoral head collapse?

Osteonecrosis and acute collapse of the femoral head occurred in a 79-year-old woman with a history of femoral neck fracture sustained 28 years previously. The occurrence of radiographic signs and clinical symptoms was associated with new functional demands on the hip because of a recent contralateral hip fracture. The femoral head collapse necessitated total hip arthroplasty. Determination of femoral head vitality at the time of arthroplasty implicated partial avascularity of the head as a cause of the collapse. With high probability, this partial avascularity was induced by the femoral neck fracture sustained 28 years earlier.

Aged↗
PubMed1991

Crossed pins vs parallel pins in the treatment of femoral neck fractures.

Twenty femoral neck fractures treated with three crossed modified Knowles pins (Gouffon pins) were compared to 20 fractures treated with three parallel pins. All patients had survived for more than 2 years after operation. The groups were comparable concerning Garden stage, reduction, and age. No significant difference concerning the failure rate was found.

Adult↗
PubMed1996

Total hip arthroplasty after acute displaced femoral neck fractures.

Displaced femoral neck fractures have three treatment options; reduction and fixation, hemiarthroplasty, and total hip arthroplasty. Total hip arthroplasty is often avoided; this is commonly owing to its assumed increased risk of dislocation. A careful and critical review of the literature reveals that it does offer certain advantages in selected patients. If acute dislocations (less than 4 months) are prevented, the dislocation rates after a fracture appear to be the same, regardless of whether a hemiarthroplasty or total hip arthroplasty is used.

Costs and Cost Analysis↗