![]() The incidence of femoral neck shortening in group A and group B was significantly lower than that in group C in postoperative 1 year, and the difference was statistically significant ( P < 0.05). The mean Harris hip scores at the final follow-up for groups A (85.6 ± 6.7) and B (84.5 ± 6.2) were significantly higher than group C (74.3 ± 8.3), and the difference was statistically significant ( P = 0.043). The incidence of avascular necrosis of femoral head in group A, B, and C was 19.05%, 20.83%, and 22.73%, respectively, showing no significant difference between groups ( P = 0.156). No significant difference in general preoperative demographics ( P > 0.05). The mean follow-up period after surgery was 22.5 ± 11.3 (range, 11–34) months. The incidence of avascular osteonecrosis of the femoral head (AVN) and the Harris scores of hip joints were compared in three groups at the last follow-up. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). MethodsĪ retrospective analysis was made on 67 cases from May 2013 to March 2019. The purpose of this study was to evaluate the clinical efficacy of Gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults. The incidence of avascular necrosis and nonunion rates remains relatively high despite the progress in our understanding and surgical technique. (white arrow) and lesser trochanter (red arrow).Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. There are separate fragments of the greater trochanter There is a fracture from the greater to the O Many intertrochanteric fracture are associated with a varus deformityĬomminuted intertrochanteric fracture. O Intertrochanteric fractures associated with a separate fragment of lesser trochanter may also include a portion of the posterior cortex of femoral neck and are considered unstable O Comminuted fractures may also manifest separate fragments of either or both of the lesser and greater trochanters O Most common of the extracapsular hip fractures There is a fracture at the base of the neck of the right femur, just proximal to the trochanters (white arrows). O May be difficult to differentiate a basicervical fracture from a non-displaced and non-comminuted intertrochanteric fractureīasicervical fracture. O Frequently associated with varus deformity O Usually easy to see on views of the hip obtained in internal rotation On the lateral view, the same step-off can be seen (red arrow) as well as the impaction (white arrow). On the frontal view, there is a step-off in the cortex superiorly (red arrow) while there is abnormal overlapping of the femoral head and neck (white arrows) due to impaction. § May require additional imaging such as MRI for confirmation of fracture ![]() O Pitfall: a rim of osteophytes may form around the femoral head and project over the neck mimicking the sclerotic line of a subcapital fracture O There may be a discontinuity in the normal smooth curve of the superior aspect of the femoral neck as it joins the head O White line of increased density of impacted bone may be seen at base of femoral head O Most common intracapsular fracture of the hip O The more displaced the fragments are, the higher the rate of complications Intracapsular fractures have a higher incidence of nonunion and avascular necrosis of the femoral head (up to 35%) than extracapsular fractures.O Intertrochanteric and subtrochanteric are extracapsular O Subcapital, transcervical and basicervical are intracapsular Hip fractures can be classified as to their geographic position as: subcapital, transcervical, basicervical, intertrochanteric and subtrochanteric.O The femoral neck will be seen in profile when the leg is held in internal rotation O When further imaging is required, MRI or nuclear medicine scans are used most often utilized O Conventional radiography is the study of first choice Most hip fractures occur in Caucasian women.In younger individuals, hip fractures are often the result of high velocity, high impact trauma.O Most hip fractures in the elderly (90%) occur as a result of a fall, frequently a minor fall such as from the standing position Conditions that predispose to hip fractures include aging, osteoporosis and osteomalacia.Hip fractures are associated with a substantial mortality, as many as 15-20% dying within one year of the fracture.
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