The Results of Treatment in Femoral Neck Fractures: The Clinical Study
10.4055/jkoa.1986.21.6.1039
- Author:
Han Koo LEE
;
Sang Hoon LEE
;
Youn Soo PARK
;
Ji Ho LEE
- Publication Type:Original Article
- Keywords:
Femoral neck fracture;
Internal fixation;
Endoprosthesis;
Total hip replacement arthroplasty
- MeSH:
Acetabulum;
Arthritis, Rheumatoid;
Arthroplasty;
Arthroplasty, Replacement, Hip;
Cartilage;
Classification;
Clinical Study;
Dislocations;
Femoral Neck Fractures;
Femur Neck;
Hip;
Humans;
Necrosis;
Osteoarthritis;
Osteoporosis;
Seoul
- From:The Journal of the Korean Orthopaedic Association
1986;21(6):1039-1046
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We analyzed ninety one fractures of femoral neck treated with surgery and followed for more than 2 years at Seoul National University from January 1977 to June 1983. Of these, 45(49%) were treated with internal fixation(compression hip screw or Knowles' pinning), 26(29%) with primary endoprosthesis, 20(22%) with total hip replacement arthroplasty. The criteria for internal fixation were fresh fracture that could be reduced satisfactorily and the age of the patient were under 65 years. The criteria for endoprosthesis were displaced subcapital or transcervical type or severe osteoporosis with intact acetabular cartilage. The criteria for total hip replacement arthroplasty were neglected fractured patients with significant medical problems, including cardiovascular, pulmonary, and renal disease, that posed significant risks for a second operation, and patients who had previous hip disease such as degenerative arthritis or rheumatoid arthritis. Following results were obtained. 1. In our series, the most frequent occurrence of femoral neck fractures was in the 7th decade(34 %), and the most common cause was fall down(72.6%). 2. In fresh fractures less than 3 weeks after injury, transcervical type (73%) according to anatomical classification and Garden's type III(44%) according to displacement were the most common type, respectively. 3. After internal fixation, 11% of avascular necrosis and 9% of non-union occurred. After endoprosthesis, 4% of acetabular protrusion, 8% of loosening and 12% of loosening and 12% of painful hip occurred. After total hip replacement arthroplasty, 10% of dislocation and 10% of loosening occurred. 4. Functional end results of excellent 56%, good 22%, fair 6% and poor 16% in internal fixation group, excellent 31%, good 38%, fair 12% and poor 19% in endoperosthesis group, and excellent 45%, good 30%, fair 10% and poor 15% in total hip replacement arthroplasty group were obtained.
