![]() ![]() ![]() The surgical techniques of the study group were briefly described as follows. Comminution of the posterior cortex of the neck was radiographically detected in 12 patients. The fracture pattern included 64 Garden Type III and 32 Type IV fractures. There were 61 transcervical and 35 subcapital fractures. 75 fractures were caused by a fall from standing, 12 were due to a fall from a height, and 9 were caused by traffic accidents. This group consisted of 96 adult patients (46 males, 50 females 57 left, 39 right) with a mean age of 46.3 years (range, 23-64 years). In control group, patients were treated by CRIF without iliac bone block grafting. Comminution of the posterior cortex of the neck was detected in 23 patients with radiographic evidence. ![]() According to Garden’s classification for femoral neck fractures, the fracture pattern included 79 Type III and 45 Type IV fractures. There were 70 transcervical and 54 subcapital fractures. The injury mechanisms included a fall from standing in 98 cases, a fall from a height in 15, a traffic accident in 10, and a crush injury in 1. There were 124 adult patients (57 males, 67 females 71 left, 53 right), with a mean age of 44.8 years (range, 20-64 years). In study group, patients were treated by CRIF and free iliac bone block grafting in a minimally invasive fashion. Patients were divided into a study group and a control group. The exclusion criteria were as follows: (1) younger than 18 years or older than 65 years (2) with osteoporosis or pathological fractures (3) base-of-neck fractures, which have a lower incidence of nonunion and osteonecrosis of the femoral head after CRIF. Adult patients with displaced subcapital or transcervical fractures were enrolled in this study. This study aimed to evaluate the preliminary clinical and radiographic findings of displaced femoral neck fractures treated following this protocol.įrom December 2008 to February 2010, 672 patients with femoral neck fractures were managed in our department. To pursue an outcome with less invasion and better functional rehabilitation, we established a protocol of closed reduction and internal fixation (CRIF) with three cannulated screws for acute femoral neck fractures, which was supplemented with non-vascularized iliac bone block graft. However, no one technique has proved entirely satisfactory. A variety of bone grafting procedures have been described to address the problem of nonunion and AVN of the femoral head, including nonvascularized bone grafting, muscle–pedicle bone grafting, vascularized bone grafting, and osteotomy. The risk for non-union is greater with displaced fractures and has been reported to be as high as 30% in some series. Non-union of femoral neck fractures has a reported incidence of 2%-22% and generally becomes apparent within 1 year. The risk of AVN has been reported to be as high as 10% to 43%. Lesser the angulation more stable the fracture with a better a prognosis.Femoral neck fractures are frequently complicated by avascular necrosis (AVN) of the femoral head and fracture non-union. Pauwel classification is based on post-reduction angulation of fracture line to the horizontal evaluated on a AP radiograph. type IV: complete, unstable and fully displaced.type III: complete, unstable and partially displaced.type II: complete, stable and undisplaced.type I: is incomplete, stable and impacted.Further, the displacement is graded as per the position of the principal (medial) compressive trabeculae. Garden classification is based on the pre-reduction displacement of the femoral head. ClassificationĪlthough many classifications are proposed Garden classification and Pauwel classification are generally followed from a practical point of view as these two systems take into consideration the stability of the fractures. The fracture line extends through the junction of the head and neck of femur. Subcapital fracture is the most common type of intracapsular neck of femur fracture. ![]()
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