Abstract
Aims: internal fixation is not generally accepted as election treatment for displaced femoral neck fractures in patients older than 70. Results and risk factors are analysed in this later group of patients. Patients and Methods: 155 patients older than 70 with displaced femoral neck fractures were treated with closed reduction and parallel cannulated screws and prospectively followed for 2 years. Patients were allowed postoperative full weight bearing with aids. Quality of reduction and osteosynthesis were radiologically analysed. Results: 24 patients (15%) were lost. At the end of follow-up 52% of patients were asymptomatic, 13% had mild pain, 28% suffered a 2nd surgery (arthroplasty) and 7% were badly ill for aditional surgery. 57% presented uncomplicated consolidation, 28% non-union and 8% ischemic necrosis. Poor-quality reduction (p= 0.039) and poor-quality osteosynthesis (p=0.051) were significant risk factors for failure. A higher age (p=0.36), displacement (Eliason criteria) (p=0.26) and delay in surgery (p=0.53) were not significant risk factors. Conclusions: closed reduction and percutaneous fixation of displaced femoral neck fractures achieves good/fair results in only 65% of patients older than 70 years. Poor-quality reduction and osteosynthesis are risk factors for clinical and/or radiological failure.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
