![]() Patients with these injuries are reasonable candidates for 6 weeks of traction, as described below, followed by mobilization out of bed to avoid excessive deformity.įor proximal femur fractures that are likely to be extracapsular (intertrochanteric or pertrochanteric), the nonoperative regimen is as follows. Hip radiography revealed an unstable, displaced, right-sided femoral neck fracture with no evidence of osteonecrosis (Figure (Figure1). If there is marked thigh shortening that increases progressively or is associated with palpable bone deformity, the patient is more likely to have an extracapsular fracture with much higher healing potential. The patient’s history was significant for hereditary thrombophilia (Factor V Leiden) and secondary anemia. displaced subcapital fractures of the femur. Less common associated injuries have also been described including ipsilateral femoral head fracture dislo-cationsandacetabularfractures8,9. ![]() Traction can be omitted or discontinued, and the patient should be mobilized as soon as comfort permits. Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head. A new method for prognostication of non-union in subcapital femoral neck fractures is presented. additional fracture, commonly ipsilateral diaphy-seal femur fracture 1, 7 (Fig. Nonoperative treatment of such patients is not based upon bone healing, which, as noted, does not occur without surgical treatment. If a radiological diagnosis is not available, the possibility of a displaced intracapsular fracture of the proximal femur may be suggested by external rotation with slight to moderate shortening (2.5–5 cm), which increases only slightly with proximally directed pressure on the leg. These fractures will usually not unite with nonsurgical treatment, and mobilization of the patient as a whole will minimize systemic complications. displaced intracapsular hip fractures in healthy older patients. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with preexisting disease in the same hip joint (total hip replacement).Once a radiological diagnosis has been made, a decision about nonoperative management can be taken.įor nonimpacted intracapsular fractures, the best nonsurgical care is to relieve pain and mobilize the patient despite the fracture. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. Undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. subcapital hip fracture(tw) OR intracapsular collum fracture(tw) OR. These 18 fractures were treated by closed reduction and internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. displaced femoral neck fracture in adults. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slipdown accident and 4 were associated with definite osteoporosis according to the Sing's classification. Many factors about this fracture in itself were noted, but we have analyzed 18 femur neck fracture of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. ![]() The distal femur was displaced cranially and laterally. Findings: There was a fracture of the high femoral neck on the right. Figure 14.12B X-ray of the femur, post-operative arthroplasty Imaging Assessment. Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. On the other hand, we believe that the advantages include not having any losses during follow-up and a uniform sample. Figure 14.12A X-ray of the femur, pre-operative femoral neck fracture.
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