Early return to function in young adults with neglected femoral neck fractures

Clinical Orthopaedics and Related Research
Amit Roshan, Shatrughna Ram

Abstract

Neglected femoral fractures in young adults are a challenge to the orthopaedic surgeon, requiring prolonged treatment and with attendant risks of nonunion. We postulated treatment in this group by accurate reduction, two cannulated screws, and whole free fibular autograft would allow early mobilization and provide good bony union. Thirty-two patients aged 18 to 50 years were treated at our center in this manner. They presented to our center 3 to 6 months after injury, and had Garden's Grade III/IV fractures with varying degrees of neck resorption, but no avascular necrosis. No plaster was applied, and early return to function was encouraged. Bony union was achieved in 29 (90.6%) patients at a mean of 19.2 weeks (range, 16-24 weeks). All patients with union had good function at long-term followup at an average of 6.1 years postoperatively (range, 2-12 years), and the average Harris hip score was 87.1 points (range, 74.5-94 points). Our procedure allows early return of function in young, active patients disabled by old femoral neck fractures compounded by lack of early treatment.

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Citations

May 26, 2012·Current Reviews in Musculoskeletal Medicine·David A Forsh, Tania A Ferguson
Jul 2, 2008·Clinical Medicine & Research·Amit Roshan, Shatrughna Ram
Apr 9, 2016·Acta ortopedica brasileira·Carlos Roberto SchwartsmannMarcelo Faria Silva
Jan 15, 2009·Clinical Orthopaedics and Related Research·Narender Kumar MaguRochak Tater
Jul 2, 2019·Journal of Orthopaedic Trauma·Dheenadhayalan JayaramarajuRajasekaran Shanmuganathan
Jun 29, 2012·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Xuetao XieYoushui Gao
Jan 26, 2018·Revista Brasileira De Ortopedia·Carlos Roberto SchwartsmannAry da Silva Ungaretti Neto
Sep 21, 2012·The Journal of Bone and Joint Surgery. American Volume·Brett D CristMark A Lee
Apr 20, 2010·The Orthopedic Clinics of North America·Jason A LoweTania A Ferguson

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