Results of Screw Fixation for Displaced Femoral Neck Fracture / 대한정형외과학회잡지

ABSTRACT

PURPOSE: This study retrospectively reviewed the results of a closed reduction and internal fixation with cannulated screws for a displaced femoral neck fracture. MATERIALS AND METHODS: Among 631 patients between January 1991 and December 2000, 27 patients classified as Garden stage III or IV were treated with a closed reduction and internal fixation with cannulated screws. The mean follow-up duration was 4.5 years. The mean age of the patients was 56.5 years. RESULTS: Union and the restoration of function was observed in 15 cases (55.6%), and failure occurred in 12 cases (44.4%). The cause of failure was early stage reduction loss due to a failure to obtain anatomical reduction on the surgical field in 4 cases, reduction loss and displacement during the follow up period after an appropriate reduction at surgery in 4 cases and avascular necrosis in 4 cases. Seven cases were converted to a total hip arthroplasty, 4 cases were converted to bipolar hemiarthroplasty and 1 case is currently being followed up. CONCLUSION: A closed reduction and internal fixation for displaced femoral neck fracture showed a high failure rate. Therefore, an accurate anatomical reduction, firm internal fixation and efforts to prevent further unnecessary vascular injury will be needed to reduce the high failure rate and complications.