Analysis of secondary displacement and femoral head necrosis after conservative treatment in undisplaced femoral neck fractures
- VernacularTitle:股骨颈骨折保守治疗继发移位及头坏死的调查分析
- Author:
Ning LI
;
Aqin PENG
;
Jing CAO
- Publication Type:Journal Article
- Keywords:
femoral neck fracture;
conservative treatment;
secondary displacement;
femoral head necrosis
- From:
Orthopedic Journal of China
2006;0(18):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]Through the clinical investigation of the conversative treatment of undisplaced femoral necks,to analyze the occurrence of secondary displacement and femoral head necrosis.[Method]The medical records of 216 patients with undisplaced femoral neck fractures who were primarily treated conservatively from January,2000 to January,2004 were analyzed.Among that,186 cases is in accordance with the selected standard,which were consisted of 82 men and 104 women.(the average age 67.5).One hundred and forty-one fractures were given to bed rest in rotation-proof shoes,and walking on the crutches was followed after four weeks.Forty-five patients began to get out of bed with double crutches on the third day.When displacement happened,the operation was carried out.Once X-rays showed the fracture line unclearly,it is considered as bone healing.The early stage of femoral head necrosis was defined by sclerotic region or cyst in the femoral head.[Result]Sixty-eight fractures(36.6%) united and secondary considered displacement occurred in 118 cases(63.4%); the average time was 16 days (2～68 d) after injury when the displacement is found.In all primary healing patients,femoral head necrosis rate was 25%.The discovery time of necrosis was between 4 and 18 months,the most was 36 cases in the interval of 6 to 12 months.As for patients of secondary displacement,92 for closed reduction and hollow screws fixation,and the head necrosis happened in 55 patients(59.8%).The discovery time was from 4 to 18 months,the most in 6 to 12 months was 36 cases.The operation of open reduction and internal fixation with hollow screws was in 26 cases,73% of necrosis rate for it.The time was range from 3 to 12 months,11 case was the most in the period of 3 to 6 months.[Conclusion]Undispalced femoral neck fractures treated conservatively bear higher risk of secondary displacement and femoral head necrosis.In addition with more mortality and general complications,we therefore recommend primary operative stabilization of undisplaced femoral neck fractures.
