Clin Orthop Surg.  2016 Jun;8(2):146-152. 10.4055/cios.2016.8.2.146.

Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures

• Kang JS
• Moon KH
• Shin JS
• Shin EH
• Ahn CH
• Choi GH

• KMID: 2412338
• DOI: http://doi.org/10.4055/cios.2016.8.2.146

Abstract

BACKGROUND
Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures.
METHODS
This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months).
RESULTS
Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck.
CONCLUSIONS
The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures.

Keyword

Femoral neck fractures; Fracture fixation; Risk factors

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Femoral Neck Fractures/diagnostic imaging/*epidemiology/*surgery
Follow-Up Studies
Fracture Fixation, Internal/*methods/*statistics & numerical data
Humans
Incidence
Male
Middle Aged
Risk Factors
Young Adult

Figure

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  Fig. 1 A 51-year-old woman visited the Emergency Medical Center of Inha University Hospital for left hip pain after car accident. (A) Initial hip joint anteroposterior (AP) and axial views show subcapital femoral neck fracture. (B) Immediate postoperative hip joint AP and axial views. (C) At postoperative 2 years, avascular necrosis of femoral head was diagnosed.

• 

  Fig. 2 A 68-year-old man visited the Emergency Medical Center of Inha University Hospital for right hip pain after a 1.5-m fall. (A) Initial hip joint anteroposterior (AP) and axial views show subcapital femoral neck fracture. (B) Immediate postoperative hip joint AP and axial views. (C) Firm fixation was not achieved and nonunion was noticed at postoperative 1 year.

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