Abstract
Femoral neck fractures in young adults remain a major problem in orthopaedics. Although treatments using cannulated screws and sliding hip screws are widely accepted, they pose significant clinical challenges. In the present study, we evaluated the outcome of treatment using cloverleaf locking plate fixation (augmented with the addition of addition of nonvascularised autologous bone grafts for neglected fracture). Fourteen patients were investigated in this cross-sectional study. Union times and Harris hip scores were analysed by independent T-test based on displacement (displaced vs. nondisplaced) and type (acute vs. neglected) of fracture. No difference in union time was found between acute and neglected groups and between nondisplaced and displaced fractures. Harris hip scores were similar between acute and neglected groups and between non- and displaced group. Cloverleaf locking plate fixation is a viable alternative method for stable fixation of femoral neck fractures in young adults. Femoral neck fracture, young adult, cloverleaf locking plate, Harris hip score, union rate.
Highlights
Fractures of the femoral neck in young adults have been regarded as a challenge in orthopaedics 1, 2
Non-union rates for femoral neck fractures reach 33% while the avascular necrosis accounts for 16 % of complications 1
In this cross-sectional study, we reviewed all patients age 15to 55-years-old who were treated between January 2003 and July 2010 with a diagnosis of femoral neck fracture and treated using the cloverleaf locking plate
Summary
Fractures of the femoral neck in young adults have been regarded as a challenge in orthopaedics 1, 2. Non-union rates for femoral neck fractures reach 33% while the avascular necrosis accounts for 16 % of complications 1. Cannulated screws, sliding hip screws, and proximal femoral locking plates are three widely-used internal fixation devices for femoral neck fracture in young adults[3]. Cannulated and sliding hip screws allow dynamic compression of the fracture site during weight bearing, they cannot prevent secondary limb shortening due to the lateralization of the head or neck fragment from gliding along the screw 4. Both carry a high risk of mechanical fracture, especially cutout of the implant from the femoral head .5,6. Showing promising results, such findings may not be applicable in the young population as the study was conducted in an elderly cohort with a mean subject age of 75-years-old and had neither control nor randomization
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