O3321 ALTERNATIVE METHOD OF CLOSED REDUCTION IN DISPLACED SUBCAPITAL FRACTURES IN AGES BETWEEN 65 AND 70 YEARS

Abstract

Aims: Demonstration of our results from treating displaced femoral neck fractures with a new method of closed reduction and internal þxation. Methods: Between 1995 and 1999 we treated 37 patients (21 female and 16 male) with displaced subcapital femoral fractures in the age group between 65 and 70 years. The selection of the appropriate treatment was according to our treatment algorithm based on the age, the displacement of the fracture, the general physical condition, the bone density and the functional demands of the patient. We performed closed reduction using an alternative method. The patient is placed on the traction table without traction of the injured limb. We apply traction on the abducted (> 45¡) healthy limb until the pelvis is mobilized. Finally, a radiological check is performed to decide whether we should modify the traction. This method is also used in other age groups. In 1 case closed reduction was not successful and an open reduction was performed. As a method of internal þxation we used 3 cannulated hip screws. Follow-up of the patients exceeded the period of 2 years. Results: The average Harris Hip Score at 2 years was 76. There were 3 cases of avascular necrosis and 2 cases of non-union of the fracture. In all these 5 patients we performed a conversion to total hip arthroplasty. Conclusions: Although displaced subcapital femoral fractures still remain the unsolved fractures, especially in ages between 65 and 70 years, proper selection of patients and satisfactory reduction of the fracture are the most important factors for a successful internal þxation of the fracture. The proposed alternative method of closed reduction leads to favorable results, comparable to the classical methods of closed reduction.