PMID: 16613748Apr 15, 2006Paper

Fractures of the femoral neck: a review and personal statement

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
Ernst L F B Raaymakers

Abstract

The number of hip fractures will increase enormously in the decades to come as will the cost of treatment of these patients do. In the USA the annual cost has estimated to be nearly $10 billion. Hip fractures, therefore, represent an enormous socio-economic and medical problem and challenge (orthopaedic) surgeons an anaesthetists to find the cheapest and most effective way to treat them. At the same time the search for preventive measures should be continued. Biphosphonates and hip protectors seem to be able to decrease the risk of suffering a hip fracture with 50%. The first classification of femoral neck fractures, proposed by Abraham Colles, in displaced and non-displaced (impacted) fractures appears to be still the most useful one. The Pauwels classification cannot be applied to the preoperative x-ray, because the fractured leg is always in external rotation. The Garden classification is not reproducible and does not lead us to the right treatment. Stability and healing chances of impacted fractures depend especially on age and general condition. In patients under 70 years of age without co-morbidity, the secondary instability rate after non-operative treatment is very low: 5%. In elderly people with multiple co-morbidity s...Continue Reading

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