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Displaced femoral neck fractures in the young: significance of posterior comminution and raised intracapsular pressure

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Osteosynthesis in fracture neck of femur (NOF) in young is a universally acceptable procedure. Various factors affect the outcome; with AVN (avascular necrosis) and non-union primarily contributing to adverse results in such patients. To identify factors affecting outcome of displaced fracture NOF, a prospective cohort study was carried out in the setting of a tertiary care centre in developing country.

Methods

27 consecutive patients with displaced fracture NOF suitable for osteosynthesis underwent closed reduction and fixation with three 6.5 mm cancellous cannulated screws. A record of posterior comminution and its extent (as seen on CT scan) and the intracapsular pressure difference between the fractured and the opposite side was kept in all the patients. The patients were followed-up for 1 year. The main outcomes measured at 1 year were non-union (as identified by CT scan) and AVN (as identified by bone scan).

Results

Cases with pressure difference >30 mm were found to have a higher rate of AVN and this result was found to be statistically significant (p value 0.034). The patients with significant posterior comminution were found to have higher non-union rates and this result was also found to be statistically significant (p value 0.04).

Conclusions

Prognosis of displaced fracture NOF is significantly associated significant with posterior comminution and intracapsular pressure difference between fractured and normal side.

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Authors and Affiliations

  1. Department of Orthopaedics, P D Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India

    Saurabh Rawall

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Bidre Upendra, Bhavuk Garg, C. S. Yadav & Arvind Jayaswal

  3. Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Kamal Bali

Authors
  1. Saurabh Rawall
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  2. Kamal Bali
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  3. Bidre Upendra
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  4. Bhavuk Garg
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  5. C. S. Yadav
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  6. Arvind Jayaswal
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Correspondence to Kamal Bali.

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Rawall, S., Bali, K., Upendra, B. et al. Displaced femoral neck fractures in the young: significance of posterior comminution and raised intracapsular pressure. Arch Orthop Trauma Surg 132, 73–79 (2012). https://doi.org/10.1007/s00402-011-1395-1

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  • DOI: https://doi.org/10.1007/s00402-011-1395-1

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