Hip Pelvis.  2014 Dec;26(4):263-268. 10.5371/hp.2014.26.4.263.

The Result of In Situ Pinning for Valgus Impacted Femoral Neck Fractures of Patients over 70 Years Old

• Kim YC
• Lee JY
• Song JH
• Oh S

• KMID: 1907703
• DOI: http://doi.org/10.5371/hp.2014.26.4.263

Abstract

PURPOSE
We aimed to evaluate the outcome of fixation with cannulated screws for valgus impacted femoral neck fractures in patients over 70 years of age.
MATERIALS AND METHODS
We reviewed the outcome in 33 patients older than 70 years with valgus impacted femoral neck fractures who were treated with cannulated screws fixation from May 2007 to December 2010. These patients were followed for at least a year. We assessed the fixation failure rate, body mass index (BMI), bone mineral density (BMD) of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation.
RESULTS
We identified six patients (18.2%) with failure. Two patients with subtrochanteric fractures through the screw insertion site and another patient with osteonecrosis were excluded from the fixation failure group. No difference was found in age, BMI, BMD of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation between failure and non-failure groups.
CONCLUSION
The failure rate of cannualted screw fixation for valgus impacted femoral neck fractures in the elderly patients was not low. Risk of failure should be considered in the management of these patients and accurate assessment for fracture type should be performed using computed tomogram and clinical evaluation.

Keyword

Valgus; Impacted; Femoral neck fracture; Internal fixation; Elderly patient

MeSH Terms

Aged
Body Mass Index
Bone Density
Femoral Neck Fractures*
Femur
Hip Fractures
Humans
Joints
Osteonecrosis

Figure

• 

  Fig. 1 Eighty two year-old female patient with valgus impacted right femoral neck fracture. (A) Preoperative plain film shows valgus impacted neck fracture in the right femur. (B) In situ internal fixation with 4 cannulated screws. (C) Six weeks after the operation, fixation failure occurred.

• 

  Fig. 2 Seventy two-year-old female patient with valgus impacted right femoral neck fracture. (A) Preoperative plain film shows valgus impacted neck fracture in the left femur. (B) In situ internal fixation with 4 cannulated screws. (C) Four weeks after the operation, subtrochanteric fracture through the pin insertion site occurred after slip down.

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