Femoral neck fractures: a cohort comparison of nonunion and complication rates after ballistic versus blunt mechanism fractures.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations Conflict of interest The authors have no relevant financial or nonfinancial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article. 5. Zentralbl Chir. 1995;120(11):841-9. [Medial femoral neck fracture--femur head preserving therapeutic concepts]. [Article in German] Dávid A(1), Richter J, Hüffner T. Author information: (1)Chirurgische Universitätsklinik und Poliklinik, BG-Kliniken Bergmannsheil, Bochum. Intracapsular femoral neck fractures of patients younger than 65 should be treated by open or closed reduction and internal fixation with two to four lag screws. Garden I fractures should also be treated by percutaneous screw fixation to prevent a delayed dislocation. If the fracture is dislocated (Garden II-IV) immediate reduction and internal fixation is mandatory to improve the blood flow by "unkinking" of the supporting vessels. The rate of femoral head necrosis is about ten to fifty percent, according to the grade of posttraumatic dislocation. Early stages of total or partial femoral head necrosis can be successfully treated by vascularized cortical bone grafts. In our institute a graft vascularized by the quadratus femoris muscle is preferred. Valgisation osteotomy, alloarthroplasties and arthrodeses in very young people are performed in cases of irreversible total femoral head necrosis.