A Clinical Study on the Multiple Pin Fixation of the Femoral Neck Fracture

Lee, Kwang Suk; Hur, Chang Yong; Park, Sang Won; Kim, Hak Yoon; Kang, Oh Yong

Abstract

Fractures of the neck of the femur have always presented great challenges to orthopedic surgeons and still remain as one of the unsolved fracture as far as treatment and results are concerned. With life expectancy increasing with each decade, becoming more and more patients suffering from femoral neck fractures and their sequelae. The objoct of this study is to observe the relationship between the clinical results and the degree of displacement of fracture, degree of osteoporosis and duration between injury and operation in femoral neck fractures treated with multiple pin fixation. The author clinically analyzed 56 patients of the femoral neck fractures treated with closed reduction and multiple Knowles pinning followed by more than 1 year at Korea University Hospital from January 1986 to December 1991. There were 20 male and 36 female. The age of patients were ranged from 32 to 88 years(average:65.1 years) and most commonly occurred in 7th decade (23cases,41%). The most common cause was slip down(44 cases;79%). The most common type of fracture was stage III (48%) following to Gardens classification. The obtained results were as follows; 1. Union occurred in 49 cases(88%). 2. Among fifty-six cases, five cases(9%) of avascular necrosis, two cases(4%) Of non-union, two cases(4%) of malunion and one case of posttraumatic arthritis were occurred. 3. The functional results by Lunceford criteria were excellent in 30 cases(53% ), good in 13 cases(23%), fair in 5 cases(10%) and poor in 8 cases(14%). 4. Unsatisfactory results were noted in Garden stage II or IV, osteoporosis below Singh index 3 and delayed treatment over 1 week. Above results suggest that multiple Knowles pinning in femoral neck fractures offers high union rate and low complication rate, and so is also one of salvaging method of femoral head.