A Clinical Study of Femoral Neck Fracture Over Age of 50 Years

Park, Hui Wan; Jahng, Jun Seop; Kang, Koon Soon; Kang, Kyung Hoon

Abstract

We clinically analysed 125 fractures of femoral neck which had been operated at the Department of Orthopedic Surgery, Yonsei University College of Medicine from January 1976 to December 1985. Of there, 45 fractures were treated with internal fixation, 43 fractures with primary hemiathroplasty, 37 freactures with total hip replacement arthroplasty. The criteria for internal fixation was fracture that could be reduced satisfactorilly and the age of the patients were under 65 years. The criteria for primary hemiarthroplasty was in elderly patient over 65 years, displaced, comminuted subcapital of trascervical fractures, irreducible fractures, pathological fractures and patients having generalised disease or senile psychosis. The criteria for total hip replacement arthroplasty was neglected fractured paients with significant medical problems and patients who had previous hip disease such as degenerative arghritis or rheumatoid arthritis. Following results were obtained. 1. Subcapital type(75%) according to anatomical classification and Graden type III,IV(80%) according to displacement were the most common type, respectively. 2. In cases of internal fixation, accurate medial cortical contact was required and redis-placement and collapse of fragments were prevented by supplementary fixation. 3. The overall rate of osteoporosis was reported to be 85%(below Singh index IV) in our series. The study should be directed not only on the fracture treatment but also on the prevention of refracture via the study of osteoporosis. 4. Good functional end results were obtained in 77% of the internal fixation group and primary hemiarthroplasy group. Internal fixation may be advantageous for femur neck fracture of elderly than arthroplasty in view of biomechanical status of hip joint.