The Result of Osteosynthesis for Femur Neck Fracture in Old Age Patients

Suk-kyu Choo; Hyoung-Keun Oh; Jong-In Kim; Hee-Du Lee; Goo-Rak Jang

doi:10.5371/jkhs.2011.23.1.32

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Choo, Oh, Kim, Lee, and Jang: The Result of Osteosynthesis for Femur Neck Fracture in Old Age Patients

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(1): 32-38.

Published online: 31 March 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.1.32

The Result of Osteosynthesis for Femur Neck Fracture in Old Age Patients

Suk-kyu Choo, MD, Hyoung-Keun Oh, MD, Jong-In Kim, MD, Hee-Du Lee, MD, Goo-Rak Jang, MD^*

Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, Koyang, Korea.

^*Department of Orthopedic Surgery, Jung Ang Janglim Hospital, Busan, Korea.

Address reprint request to Hyoung-Keun Oh, MD. Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, 2240 Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Korea. TEL: +82-31-910-7968, FAX: +82-31-910-7967, osd11@paik.ac.kr

Received 2 October 2010 Revised 28 February 2011 Accepted 28 February 2011

Abstract

Purpose

We wanted to investigate the radiographic and clinical results of internal fixation with cannulated screws in elderly patients with femoral neck fracture.

Materials and Methods

We reviewed the results of 47 cases of elderly patients with femoral neck fractures that were treated by osteosynthesis from May 2000 and March 2009 and these patients could be followed up for more than one year. There were 11 males and 36 females with a median age of 72 years (65~85 years). They were classified by the Garden stage. The number of stage I and II fractures was 34 and 16, respectively. The postoperative follow up period was 24 months (12~84 months). The union time, horizontal shortening and complications were investigated. Walking ability was evaluated by Koval's scoring system and the quality of life was measured by the Korean EQ-5D.

Results

The average union time was 4.4 months. The complications were one case of nonunion, 6 cases of avascular necrosis and one case of subtrochanteric fracture. The average of the horizontal shortening was 6.815 mm (0~20 mm) in the fracture site. The walking ability was on average 1 step down and it was possible to walk independently using a walker for 69% of the patients. The Korean EQ-5D quality of life was reduced from 0.856 to 0.561 (P <0.01).

Conclusion

In elderly patients with femur neck fracture, the decreased abductor moment arm may reduce the quality of life and walking ability after cannulated screw fixation.

Keywords: Femur, Femoral neck fracture, Cannulated screw, Osteosynthesis

Figures and Tables

Fig. 1

The Measurement of Horizontal Shortening of Femur neck. The length was measured from (a) medial border of femur head to (b) lateral border of greater trochanter. The last follow up X-ray: To Compare with contralateral side of hip.

Fig. 2

(A) Preoperative radiology showed femur neck fracuture (Garden stage II). (B) Immediate postoperative radiology showed well reducted state. (C) Non-union was remained after internal fixation by cannulated screws. (D) The hemiarthroplasty was performed for the treatment of non-union.

Fig. 3

(A) Preoperative radiology showed femur neck fracuture (Garden stage I). (B) Immediate postoperative radiology showed well reducted state. (C) Avascular necrosis of femur head was developed. (D) The total hip arthroplasty was performed.

Fig. 4

(A) Preoperative radiology showed femur neck fracuture with minimal displacement. (B) Immediate postoperative radiology showed well reduction state. (C) The follow up radiology showed subtrochanteric fracture of femur. (D) The internal fixation was done by PFN.

Table 1

Walking Ability by Koval

Table 2

The Korean Version of the EQ-5D

Table 3

Comparison of Two Groups According to Walking Ability

^*P values of <0.05 were considered the level of statistical significance difference.

Table 4

Comparison of Two Groups According to Quality of Life (Korean EQ-5D)

^*P values of <0.05 were considered the level of statistical significance difference.

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