Fracture of the Femoral Neck: SOIB Method

Abstract

Treating fractures of the proximal femur remains a controversial problem. Fractures of the femoral neck occur almost exclusively amongst the elderly (fractures due to bone frailty associated with osteoporosis), whereas fractures in younger people are due to high-energy trauma. The current treatment trend in clinical practice and the literature for these fractures is prosthetic replacement. In this article the authors describe the case of an 81-year-old woman who underwent osteosynthesis due to a left subcapital fracture (Garden II) using the SOIB method. The operation consisted in stabilising the fracture with SOIB screws, a special device equipped with holes along the whole length, and filling the proximal femur through the screws with an osteoconductive material. The SOIB method protected the limb from further trauma. In the literature an incidence up to 20% of contralateral hip fracure is described. Osteosynthesis of a femoral neck fracture has a higher risk of failure in the elderly due to poor bone quality: the SOIB method is a less invasive operation and thanks to the selective introduction of osteoconductive materials reinforces the osteoporotic bone, reducing complications to a minimum. In case of hip fracture a treatment for osteoporosis is mandatory.