Femoral Neck Fracture

Hyung-Ku Yoon; Jin-Myong Dan

doi:10.5371/jkhs.2010.22.1.13

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Yoon and Dan: Femoral Neck Fracture

Review Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(1): 13-19.

Published online: 31 March 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.1.13

Femoral Neck Fracture

Hyung-Ku Yoon, MD, Jin-Myong Dan, MD^*

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea.

^*Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, Gyeongsangbuk-do, Korea.

Address reprint request to Jin-Myong Dan, MD. Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, 855 Hyungkok-dong, Gumi-si, Gyeongsangbuk-do 730-040, Korea. TEL: +82-54-450-9571, FAX: +82-54-450-9642, saos@unitel.co.kr

Received 27 July 2009 Revised 20 October 2009 Accepted 30 November 2009

Abstract

The incidence of the femoral neck fracture is increasing, and the mechanism of the injuries is quite different in the young and elderly groups (high energy injury and osteoporosis, respectively). In the young group, early anatomical reduction and rigid fixation by such measures as multiple cannulated screws are mandatory to decrease the complications. In the elderly group, hip arthroplasty is recommended to decrease the complications due to early mobilization.

Keywords: Femoral neck fracture, Cannulated screws, Hemiarthroplasty

Figures and Tables

Fig. 1

Bone density of cadaveric femoral heads.

Fig. 2

The arterial supply of the femoral head.

Fig. 3

Garden allignment index. An angle of 160° to 180° on both anteroposterior and lateral images was considered acceptable by Garden. Anatomic (left and middle) and unacceptable (right) reductions are shown.

Fig. 4

Anatomy of reduction. (A) Lowell demonstrated that the cortices of an anatomically aligned femoral head and neck will project shallow S- or reverse S-shaped curves on both X-ray views. (B) Malalignment is demonstraited by a flattening of one curve and a sharp apex on the opposite side.

Fig. 5

Configuration of pin fixation. (A) Cross-section showing the position of the screws in the femoral neck. Three screw inverted triangle configuration. (B) Four-screw diamond configuration.

Fig. 6

Preferred surgical technique of multiple cannulated screw fixation. (A) Fixed guides for triangle or diamond patterns. (B) AP projection of the placement of three parallel guide pins. (C) Lateral projection of three parallel guide pins. (D) The 6.5 mm cannulated screws of appropriate length are passed over the guide pins.

Fig. 7

Fixation of an femoral neck fracture with three parallel 6.5 mm screw in an inverted triangle configuration. (A) AP view. (B) Lateral view.

Fig. 8

Dynamic hip compression screw and sideplate with derotational screws.

Table 1

Criteria of Good Reduction and Acceptable Reduction by Garden Alignment Index.

References

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