Discussion:

FEMORAL NECK
FRACTURE

DEFINITION
o
o
o

A break in the structural continuity of bone

If overlying skin is intact : Closed fracture
If skin is not intact: Open fracture

Fracture of proksimal femur,

intracapsular fracture
Direct

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

OVERVIEW
>250,000 hip
fractures occur in the
US each year (50%
involve the femoral
neck)

80% occur in ,
Insidence; younger
doubles every 5 to 6
patients low; older
years in age >30
patient high
years.

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

FEMUR BONE

Thompson, J. Netters Concise Orthopaedic Anatomy 2nd Edition. Kansas : Elsevier.

HIP JOINT

Thompson, J. Netters Concise Orthopaedic Anatomy 2nd Edition. Kansas : Elsevier.

BLOOD SUPPLY

Thompson, J. Netters Concise Orthopaedic Anatomy 2nd Edition. Kansas : Elsevier.

BLOOD SUPPLY

Thompson, J. Netters Concise Orthopaedic Anatomy 2nd Edition. Kansas : Elsevier.

ROM ft. NVD

Thompson, J. Netters Concise Orthopaedic Anatomy 4 nd Edition. Kansas : Elsevier.

MECHANISM OF INJURY

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

DIAGNOSIS

Campbell Operative Orthopedics 12th Edition.

Rockwood and Green's Fractures in Adults (7Ed. 2010)

CLINICAL FINDINGS
in motion
shortening of
extremity

NRS : 2/10

deformity

external
rotation

pain

of

rotation in
resting position
angulation

varus

CLASSIFICATION
Classification by
Anatomic Location
Subcapital
Transcervical
Basicervical

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

Campbell Operative Orthopedics 12th Edition.

CLASSIFICATION
Pauwels
Classification
Type I <30 degrees
Type II 30 to 70 degrees
Type III >70 degrees

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

Sivananthan S, Femoral neck Fracture; Mercers Textbook of Orthopaedics and Trauma, 10 th Ed.

GARDEN CLASSIFICATION

(a) Stage I: incomplete (impacted) (b) Stage II: complete without displacement
(c) Stage III: complete with partial displacement (d) Stage IV: complete with full displacement

Pauwels classification

anatomical
classification

garden
classification

TREATMENT GOALS

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

MANAGEMENT
Non Operative
External Reduction
Gradual mobilization
Operative preferred

Cannulated screw fixation

Sliding hip screw
Hemiarthroplasty
Total Hip Arthroplasty

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 3rd Edition

MANAGEMENT

MANAGEMENT

COMPLICATIONS
Early Complication :

DVT
PE
Ulcus decubitus
Orthosatic pneumonia

Late Complication :
Osteonecrosis Avascular Necrosis of femoral head
Non union
Secondary Osteoarthritis

Koval, Kenneth J.; Zuckerman, Joseph D, Handbook of Fractures, 4th Edition

Thank You