Incidence Of Femoral Neck Fractures Research Articles

Increased Risk of 10-Year Revision Following Total Hip Arthroplasty for Femoral Neck Fracture

As the incidence of femoral neck fracture (FNF) increases with the aging population, understanding its impact on surgical outcomes is important to improving implant survival and patient satisfaction. Despite increasing use of total hip arthroplasty (THA) as management for FNF, few studies have examined long-term implant survivability. Thus, this study sought to determine the 10-year cumulative incidence of revision and indications for revision in patients undergoing THA for FNF in comparison to osteoarthritis. Patients who underwent primary THA for FNF or osteoarthritis were identified using a national administrative claims database and propensity-score matched in a 1:2 ratio based on age, gender, the Charlson Comorbidity Index (CCI), smoking, obesity, and diabetes mellitus. Kaplan-Meier and Cox proportional hazards analyses were used to observe the cumulative incidence and risk of all-cause revision, periprosthetic joint infection (PJI), dislocation, mechanical loosening, and periprosthetic fracture (PPF) within 10 years of primary THA. In total, 19,735 patients who underwent THA for FNF and 39,383 patients who underwent THA for osteoarthritis were included. The 10-year cumulative incidences of all-cause revision (7.1 versus 4.9%), PJI (5.0 versus 3.3%), dislocation (6.8 versus 3.8%), mechanical loosening (3.1 versus 1.9%), and PPF (7.8 versus 4.0%) were significantly higher for those who underwent THA for FNF versus osteoarthritis. Femoral neck fractures were associated with higher risks of revision (hazard ratio [HR]: 1.6), PJI (HR: 1.7), dislocation (HR: 2.0), mechanical loosening (HR: 1.6), and PPF (HR: 2.2) (P < 0.001 for all). Despite the advantages of THA, femoral neck fractures remain a major risk factor for long-term complications. Tailored preoperative planning, surgical techniques, and postoperative bone health optimization in these patients may help minimize poor outcomes.

Postoperative rehabilitation exercise experiences of geriatric patients with femoral neck fractures based on the perspective of medical staff: a qualitative study

BackgroundThe incidence of femoral neck fractures in older adults is increasing each year. Active and reasonable postoperative rehabilitation exercises can restore the activity of geriatric patients with femoral neck fractures to a great extent, while also avoiding bedridden complications and re-fractures. This study explores the perspectives, experiences, and recommendations of medical staff regarding the implementation status, existing problems, promoting factors, and hindering factors of post-surgical rehabilitation exercises for geriatric patients with femoral neck fractures. The ultimate goal is to further optimize rehabilitation exercise programs and to expedite this process for patients. MethodsA qualitative, descriptive phenomenological study was conducted. A total of 21 clinical medical staff were selected using the purposive sampling method for semi-structured interviews. A content analysis method was used to collate and analyze the collected interview data.ResultsA total of 2 themes and 6 sub-themes were defined. The themes consisted of multiple obstacles occurring during the implementation of rehabilitation exercises and the scientific cognition of medical staff on these exercises. Respondents found that patient initiative during rehabilitation exercises was insufficient, that the comprehensiveness and continuity of exercises could not be guaranteed, and that unification between textbook theory and clinical practice was incomplete. Moreover, respondents believed that their professional quality should be excellent, but that staffing and organizational management required optimization, and that support was required for the implementation of rehabilitation exercises.ConclusionThis study investigated the opinions and experiences of medical staff during postoperative rehabilitation exercises in geriatric patients with femoral neck fractures. Collaborative efforts should fully engage hospitals, communities, and families, enhance the alignment of health education with patient needs, advance the scientific development of an integrated medical model by refining the curriculum and teaching system, and significantly elevate the level of medical science and technology. This study will serve as a valuable reference for the establishment of future professional, and personalized rehabilitation programs tailored for geriatric patients with femoral neck fractures.

Comparison of dynamic hip screw with anti-rotation screw and femoral neck system internal fixation for the treatment of garden II-IV type femoral neck fractures.

Femoral neck fractures, which are fractures occurring from the femoral head to the base of the femoral neck, are prevalent in the elderly population. With the progression of societal aging, the incidence of femoral neck fractures has been steadily increasing, making it a significant global issue that urgently needs to be addressed. To compare the efficacy and safety of dynamic hip screw (DHS) with anti-rotation screw and femoral neck system (FNS) internal fixation for the treatment of Garden II-IV type femoral neck fractures. A total of 90 patients with Garden II-IV type femoral neck fractures were randomly assigned to either the control group (n= 45) treated with DHS and anti-rotation screw or the experimental group (n= 45) treated with FNS. Surgical outcomes, including incision size, blood loss, operation time, fluoroscopy frequency, and fracture healing time, were compared. Postoperative complication rates, reoperation rates, Harris scores, and visual analogue scale (VAS) scores were also assessed. The experimental group demonstrated significantly reduced incision length, blood loss, operation time, and fluoroscopy frequency compared to the control group (P< 0.01). No significant differences were observed in fracture healing time, Garden classification, or fracture reduction outcomes between the two groups (P> 0.05). At 6 months post-treatment, both groups showed significant improvements in Harris scores and VAS scores compared to pre-treatment (P< 0.05), with no significant differences between the groups (P> 0.05). The rates of internal fixation failure, nonunion, and avascular necrosis of the femoral head, as well as overall incidence of postoperative complications and reoperation rates, showed no significant differences between the two groups (P> 0.05). Both DHS with anti-rotation screw and FNS internal fixation demonstrated comparable efficacy and safety profiles in the treatment of Garden II-IV type femoral neck fractures. The experimental group showed advantages in terms of reduced incision length, blood loss, operation time, and fluoroscopy frequency, while maintaining similar clinical outcomes and complication rates.

Non-cannulated versus cannulated cancellous screws for the internal fixation of femoral neck fractures in osteoporotic patients: A single-blind randomized clinical trial

BackgroundThe incidence of femoral neck fractures in osteoporotic patients is rising worldwide and is associated with significant increases in healthcare and social costs, as well as dependency. Improving minimally invasive treatment strategies, including internal fixation with screws, can result in favorable clinical outcomes and lesser incidence of complications, while preserving the hip. This study compared the outcomes of using non-cannulated cancellous screws (NCS) and cannulated cancellous screws (CS) in the internal fixation of undisplaced intracapsular femoral neck fractures (UIFNF) of osteoporotic patients of Iranian descent. MethodsThis randomized clinical trial was conducted on the patients referring to an institutional tertiary hospital in northwestern Iran between March 2020 and June 2021. The patients' preoperative, perioperative, and postoperative characteristics were evaluated for at least two years. Primary endpoints were defined as the incidence of hip-related complications, while secondary endpoints were assessed based on the patients’ hip function using Harris Hip Score (HHS). ResultsFifty-seven patients with osteoporosis and UIFNF were included in the final analysis, with 27 patients in the NCS group and 30 patients in the CS group. The surgical duration, the amount of intraoperative blood loss, and the frequency of C-arm were considerably lower in the CS group (p < 0.05). The incidence of implant failure was higher in the NCS group (p = 0.04). Screw migration occurred more frequently in the CS group (p = 0.03). The HHS values were significantly higher for the NCS group than those of the CS group at both the 1-year and 2-years of follow-up assessments (1 year, p = 0.007; 2 years, p = 0.001). ConclusionFixation using CS was accompanied by enhanced perioperative outcomes and lower implant failure rates compared to the NCS group. However, patients in the NCS group posed a reduced risk of complications, including screw migration, and experienced a long-term improvement in HHS scores.

Observation of the short-term curative effect of using SuperPATH approach to treat elderly femoral neck fractures with schizophrenia.

As China enters an aging society, the incidence of femoral neck fractures is increasing year by year. For some patients, total hip arthroplasty (THA) is the treatment of choice for displaced femoral neck fractures. Schizophrenia is a common combination of elderly patients with femoral neck fractures, and there are few reports on the treatment. This study describes the short-term efficacy of the supercapsular percutaneously assisted (SuperPATH) approach in the treatment of patients suffered with displaced femoral neck fractures combined with schizophrenia. A retrospective analysis of 20 elderly patients with displaced femoral neck fractures combined with schizophrenia who underwent THA using the SuperPATH approach. Record demographic data, postoperative reexamination of X-ray film to observe the position and the loosening condition of the prosthesis, the length of hospitalization, complications in the hospital and after discharge. The Harris score of hip joint function was used to evaluate postoperative hip joint function. The average age of the 20 patients was 73.1 years. All patients were followed up by outpatient clinic or telephone. The follow-up time was 3-12 months, with an average of 9.2 months. There was no incision infection, no tissue structure damage such as important nerves and blood vessels, and no complications such as early dislocation, loosening of the joint prosthesis, and deep vein thrombosis of lower extremities. The efficacy of the last follow-up was evaluated according to the Harris score of hip joint function: an average of 91 points (78-98 points); 13 cases were excellent, 5 cases were good, and 2 cases were fair. The SuperPATH approach has the advantages of less surgical damage, shorter recovery time, good surgical safety, preserving the normal tension of the muscles around the hip joint, and reducing the incidence rate of early postoperative dislocation of the joint prosthesis. The THA of the SuperPATH approach can treat patients with displaced femoral neck fractures combined with schizophrenia safely and effectively.

An anatomically designed implant for femoral neck fractures in young adults: A hypothesis on the role of interfragmentary compression in reducing nonunion and osteonecrosis

The incidence of femoral neck fractures has increased in young adults. Although new implants and surgical techniques have been developed over the past decade, the rate of nonunion and osteonecrosis, which may be related to poor osteosynthesis stability, remains concerning. To address this issue, we propose a new implant model that has been anatomically designed for the proximal femur with the aim of improving the type of fixation currently used for young femoral neck fractures. Its use in Pauwels type III fractures was evaluated in synthetic models using applicability and biomechanical bench tests, as well as finite element simulations. The results suggest that this new implant could be used in clinical practice with a satisfactory biomechanical performance.

Proportion of stable femoral neck fracture types in different age groups: a population-based study

The treatment and incidence of femoral neck fracture (FNF) in older patients is controversial. We investigated the new AO (Arbeitsgemeinschaft für Osteosynthese) classification in patients with FNF by age to determine the proportions of stable fracture and change trends according to patients' age. We divided patients with FNF hospitalized in Xi'an Honghui Hospital from 2018 to 2020 into five groups according to age: young (<50 years), middle-aged (50-59 years), young-elderly (60-69 years), middle-elderly (70-79 years), and very elderly (≥80 years) groups. We retrospectively collected data of patients' sex, admission date, fracture side, mechanism of injury, and new AO classification. In total, 2071 patients were included for analysis, with 1329 women (64.2%); 1106 patients (53.4%) had left-side fracture. The main mechanism of injury was falling. In the young-elderly, middle-elderly, and very-elderly groups, 33.3%, 29.2%, and 24.1% had stable fracture type, respectively). The proportion of patients with FNF did not show a change trend by age during the 3-year investigation period. In our study, the proportion of older patients with FNF did not increase, and as many as a third of patients with FNF aged 50 to 70 years had stable fracture.

Comparison of femoral neck geometric parameters between Chinese and Japanese females.

Femoral neck fracture is the most serious osteoporotic fractures that is responsible for high medical costs and high mortality. Femoral neck geometric parameters (FNGPs) are important parameters that reflect the geometrical characteristics of femoral neck, and are closely related to the strength of femoral neck and the risk of fragility fracture.There are differences in the incidence of femoral neck fractures among races. However, whether there is difference in FNGPs among races is unknown.Therefore, this study aims to compare the differences in FNGPs between Chinese and Japanese females. This study was a cross-sectional study, in which 3 859 healthy females aged 10-86 (45.7±17.1) years old were recruited from Changsha City of Hunan Province and surrounding areas. The weight and height were measured and recorded, and the body mass index (BMI) was calculated. A dual energy X-ray absorptiometry (DXA) bone densitometer was used to measure femoral neck projective bone area (BA) and bone mineral density (BMD). FNGPs were calculated using the BMD and BA, which included the outer diameter (OD), cross-sectional area (CSA), cortical thickness (CT), endocortical diameter (ED), buckling ratio (BR), section modulus (SM), cross-sectional moment of inertia (CSMI), and compression strength index (CSI). The data of FNGPs in Japanese females was collected from literature. These subjects were grouped by 10-year age. The mean and standard deviation of height, weight, BMI, femoral neck BMD, and FNGPs of each group were calculated. The model with the best goodness-of-fit was selected from various mathematical regression models to analyze the distribution trend and the best fitting curve of FNGPs with age. The differences in FNGPs between Chinese and Japanese females were analyzed by using age-corresponding mean fitting curve for paired t-test, and the relative change rates of FNGPs were compared. The mean values of FNGPs were significantly different among different years old healthy females (all P<0.01). The mean values of OD, CSA, CT, SM, and CSMI in femoral neck were high at 30 to 39 years old, and then they were gradually decreased with age. The CSI reached its peak at 20-29 years old, and it was decreased gradually after 30 years old. ED and BR were at a low level before 40 years old, they were gradually increased after 40 years old, and reached the maximum average value at 80-86 years old. The variations in FNGPs with age were fitted with the best goodness-of-fit by applying the cubic regression model and the determination coefficients of regression equations (R2: 0.062-0.404) were significant (all P<0.01). The distribution trend of FNGPs with age varied with the indices, among which CSA, CT, SM, CSMI and CSI were increased with age before 35 years old, and then they were decreased with age; BR was at a low level in the early stage, and then it was increased with age after about 40 years. There were significant differences in the fitting curves of FNGPs related to age between Chinese and Japanese females (all P<0.01). The fitting curves of OD, ED, BR and SM in Chinese females were significantly higher than those in Japanese females (all P<0.01), while those of CSA and CT in Chinese females were significantly lower than those in Japanese females (all P<0.01). Before the age of 50, the curves of CSMI and CSI of Chinese females were significantly higher than those of Japanese females (all P<0.01), while after the age of 60 the situation was reversed (all P<0.01). Except for SM and CSI, there were significant differences in the rate of OD, CSA, CT, ED, BR and CSMI with age (all P<0.01). By the age of 80 years old, the rates of change in OD, ED, and BR with the age in Chinese females were increased by 0.91%,3.94%, and 47.5%, respectively, while those in Japanese females were increased by 8.57%, 15.8% and 85.3%, respectively；the rates of change of CSA, CT, and CSMI with the age in Chinese females were declined 28.0%, 29.6%, and 25.2%, respectively, while those in Japanese females were declined 29.9%, 36.2%, and 10.9%, respectively. There were significant difference in the rates of change in FNGPs with the age between Chinese and Japanese females (all P<0.01). The study reveals the variation of FNGPs with age in Chinese, and confirms that there are racial differences in FNGPs between Chinese and Japanese females, which may be one of the important reasons for the difference in the incidence of femoral neck fracture between Chinese and Japanese females.

Evaluation of functional outcome of patients with fracture neck of femur treated with Austin Moore prosthesis at government medical college, Thrissur-a prospective study during October 2019 to October 2020

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Femoral neck fractures commonly affects the elderly population. 90% of femoral neck fractures in the elderly result from simple fall. Elderly age group suffers from innumerable illnesses such as diabetes, hypertension, coronary artery disease, chronic obstructive pulmonary disease, all of which can aggravate following a femoral neck fracture because patient can become completely bedridden. The aim of treating these patients is to make them mobilize as early as possible to achieve his or her pre-fracture functional status. The incidence of femoral neck fractures is increasing dramatically as the mean age of the population increases. Prosthetic replacement allows immediate weight bearing to elderly patients and thus helps to avoid complications of recumbency and inactivity. To study the functional outcome in patients with femoral neck fractures treated with Hemiarthroplasty using Austin Moore prosthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: Prospective study was done among 42 consented patients who sustained neck of femur fractures and were admitted in department of orthopaedics, government medical college, Thrissur, between 01/10/19 to 01/10/20, who were aged above 60 years and presenting within 3 weeks of injury. Patients were followed up at an interval of 6 weeks, 3 months and 6 months functional outcome was analysed by modified Harris hip scoring system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among the 42 subjects, 52.4 % were females and the rest were males. Mean age of the study population was 71.57±7.047 years. Harris hip score at end of 6 months ranged from 35 to 94. 33.3% of hemiarthroplasties had hip score of 91-100 (excellent), 38.1% of the hemiarthroplasties had scores of 81-90 (good), 19% had satisfactory/fair results whereas only 9.5% of hemiarthroplasties fell in poor category with scores below 70.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Hemiarthroplasty with Austin Moore prosthesis is still a good option in elderly patients with femoral neck fractures.&lt;/p&gt;

Simulating Prophylactic Fixation Methods for Osteoporotic Femoral Neck Fracture Prevention.

Geriatric patients who suffer femoral neck fractures have high morbidity and mortality. Prophylactic fixation of the femoral neck is a potential avenue to reduce the incidence of femoral neck fractures. We studied 3 different implants traditionally used to stabilize the femoral neck: 6.5mm cannulated screws (CANN), the femoral neck system (FNS) (Depuy Synthes), and the dynamic hip screw (DHS) (Depuy Synthes). Five osteoporotic Sawbone femurs were used for each model and a control group. Two scenarios were investigated: single leg stance to measure construct stiffness and lateral impact to measure construct stiffness, energy to fracture, and qualitative examination of fracture patterns. Stiffness for each femur and energy to fracture for the lateral impact scenario were calculated and compared between groups using one-way ANOVA. DHS showed significantly higher stiffness than the other 2 implants and the control in single leg stance. In the lateral impact scenario, the DHS and CANN were significantly stiffer FNS and the control. Femurs implanted with CANN tended to fracture at the greater trochanter while FNS fractured in a transverse subtrochanteric pattern, and DHS fractured obliquely in the subtrochanteric region. FNS and DHS experienced fracture patterns less amenable to surgical correction. CANN and DHS proved better able to resist external forces in the lateral fall scenario. CANN also proved better able to resist external forces in the single leg stance scenario and experienced a more amenable fracture pattern in the lateral fall scenario. FNS was less able to resist external forces compared with the other implants. This work informs the potential implications between the choice of implants that, although historically have not been used prophylactically, may be considered in the future for prophylactic stabilization of the femoral neck. Cadaveric study and clinical trials are recommended for further study.

A Simple Procedure for a Common Problem: Screw/Blade Exchange for Symptomatic Lateral Hardware Associated With Fracture Compression Following Dynamic Cephalomedullary Fixation of Pertrochanteric Hip Fractures

A Simple Procedure for a Common Problem: Screw/Blade Exchange for Symptomatic Lateral Hardware Associated With Fracture Compression Following Dynamic Cephalomedullary Fixation of Pertrochanteric Hip Fractures

Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis

ObjectiveTo provide guidelines for surgery and reduce the incidence of fracture, this study analyzed the relationship between femoral fracture and related factors in direct anterior approach (DAA) total hip arthroplasty (THA) in the lateral decubitus position.MethodA retrospective series of 273 consecutive patients who underwent THA with the DAA in the lateral decubitus position was analyzed. Each surgery was performed by the same surgeon with a conventional operation bed and femoral stem. The correlations between the incidence of fracture and sex, age, body mass index (BMI), height, osteoporosis, the anterior superior iliac spine-greater trochanter distance (ASIS-GTD), and hip joint disease were analyzed by univariate analysis and logistic regression analysis.ResultsAmong all hip arthroplasty procedures, 35 hips had femoral fractures, including 30 greater trochanter fractures, 4 proximal femoral splits, and 1 femoral perforation. The incidence of fracture was 12.82%. Univariate analysis showed no significant difference in the incidence of fracture by sex, BMI, or age. However, osteoporosis caused an increase in the incidence of fracture, while the incidence of fracture decreased as height and the ASIS-GTD increased. The incidence of femoral neck fracture was lower in cases of osteonecrosis of the femoral head than in cases of other diseases. Logistic regression showed a significant correlation between osteoporosis, the ASIS-GTD, and fractures. Patients with osteoporosis had a high possibility of fracture (OR = 2.414); the possibility of fracture decreased with increasing ASIS-GTD (OR = 0.938).ConclusionLateral decubitus DAA THA can be successfully performed using a conventional operation bed and stem, effectively saving medical resources. Osteoporosis and a shorter ASIS-GTD were independent risk factors for femoral fracture.

Open femoral neck fracture of 14 years old boy treated by emergency internal fixation with additional osteomuscular pedicle graft: case report

&lt;p&gt;The incidence of femoral neck fractures in pediatric patients is rare, including &amp;lt;1% in all cases of fractures in children. The mechanism of injury is a high-energy injury that can cause a fracture in the femoral neck, open fracture cases are rare. Avascular necrosis is the most common complication. We report a fourteen year old boy who was in a road-traffic accident and had a Gustillo Anderson grade IIIA open femoral neck fracture. On the X-ray findings, we classified the type of fracture into Delbet type II. We decided to do the debridement and ORIF accompanied by an osteomuscular pedicle graft using a quadratus femoris muscle tendon fixed with 3 interfragmentary screws. Short-term evaluation shows a clinical union picture and is still well reduced without any signs of infection. Long-term evaluation of the bone healing process is needed and recognizes complications in the form of avascular necrosis of the femoral head.&lt;/p&gt;

Should advanced age be a contraindication to total hip arthroplasty in femoral neck fracture patients? A matched-control, retrospective study

IntroductionDue to demographic changes, the annual incidence of femoral neck fractures (FNF) in patients reaching the 9th and 10th decade of life is increasing. Although active and cognitively intact elderly patients could benefit from total hip arthroplasty (THA) in case of a FNF, there is no clear consensus on whether THA should be performed in this particular subgroup of patients with very advanced age. The purpose of this study was to report the complication rate, mortality, clinical outcomes and quality-adjusted life year (QALY) gained in patients treated with total THA for FNF, while having exceeded the mean life expectancy at the time of surgery, compared to a younger control group. Materials and MethodsPatients treated with THA through a direct anterior approach (DAA) for FNF and exceeding the average life expectancy in Switzerland (age ≥ 83 y, n = 45) were matched for gender, body mass index (BMI) and ASA score with patients under the age of 83 (age = 65-83, n = 45). Perioperative complications, clinical and radiologic outcomes, as well as mortality were compared between groups. ResultsTotal complication rate did not differ significantly with 22.2% in the older group compared to 17.8% in the control group. The 30-day and 1-year mortality was slightly but not significantly higher in the older group (2.2% and 8.9% vs. 2.2% and 2.2%). The average QALY gained was 3.4 years and 4.1 years for the older group and their younger counterparts, respectively. ConclusionTHA through the DAA for FNF in cognitively intact and active patients might be a credible and safe option even after reaching mean life expectancy with excellent functional outcomes and similar surgery-related complications compared to patients younger than 83 years. Our results imply that an advanced age should not be considered a contraindication for THA in case of a FNF.

Screw trajectory affects screw cut-out risk after fixation for nondisplaced femoral neck fracture in elderly patients.

Incidence of femoral neck fracture has risen with the aging of the population and has critical implications with regard to patient death, functional dependence, and social costs. Screw fixation using triangular configurations and calcar placement are still the preferred treatment for nondisplaced femoral neck fracture, to reduce the risk of loss of reduction and nonunion. However, this method is still controversial in terms of the effects of screw trajectory, including parallel or nonparallel configurations, on fixation of femoral neck fractures. This study aimed to compare the incidence of complications between patients who have undergone fixation with a parallel or a nonparallel screw trajectory. We retrospectively analyzed 55 patients who were older than 60 years and diagnosed with nondisplaced femoral neck fracture from March 2014 to March 2016, and who were treated with cannulated screw fixation in our institution. Patient demographics, radiographic parameters including reduction quality, screw trajectory, and complications during the follow-up period were all evaluated. The overall complication rate for screw fixation in elderly patients was 23.6%, and screw cut-out was the most common complication, occurring in 14.5% of all enrolled patients. Also, we found that screw cut-out occurred in more osteoporotic patients, and all screw cut-outs were in groups treated with a nonparallel screw trajectory. However, parallel screw fixation was inclined to back out more after fracture healing and had a lower risk of postoperative screw cut-out. Our results suggested that fixation with nonparallel screws for nondisplaced femoral neck fracture in elderly and osteoporotic patients might interfere with shortening of the femoral neck along with fracture healing, leaving patients at risk of postoperative screw cut-out from the femoral head.

The functional outcome in patients treated with THA with acute fracture neck of femur in patients aged above 60 years using Harris hip score

The incidence of femoral neck fractures is increasing continuously among the aging population. The numbers of hip fracture are expected to increase from 1.7 million in 1990 to 6.3 million during the year 2050. The femoral neck fractures and pertrochanteric fractures are of approximately equal incidence and together make up to 90% of the proximal femur fractures and the remaining 5 – 10% is subtrochanteric. A total 40 patients with acute fracture of neck of femur aged above 60 years treated with THA attending the Department of Orthopedics, constituted the sample size. The sample size was calculated by assuming a Harris hip score of 81 points with a standard deviation of 5, with a relative precision of 2% (Alpha of 5%, 95% confidence interval). The Harris hips score was 81.82 at the end of 6 months of follow up, 86.07 at the end of 3 months and 91.1 at the end of 6 months. The mean difference in Harris Hip score between the 6 weeks versus 3 months was 4.25, 9.27 between 6 weeks versus 6 months and 5.02 between 3 months versus 6 months. There was a statistically significant difference in the Harris Hip score in the period of follow up.

Perinatal bone and calcium metabolism in the patient complicated with renal dysfunction.

The incidence of pregnancy complicated with renal dysfunction has tended to increase due to aging and progress in the treatment methods. Generally, pregnancy is allowed only in women with normal renal function and in patients with mild renal insufficiency; therefore, the incidence of osteoporosis and the resulting fragile fracture is rare during pregnancy complicated with renal dysfunction. In recent years, the incidence of pregnancy in dialysis patients and in patients who have undergone kidney transplantation has been increasing due to the progress in treatment methods. Eventually, it has become possible for patients with renal dysfunction to give birth as long as they fulfill certain conditions for pregnancy; however, the rate of preterm births has remained high. The incidence of femoral neck fracture has been about 5 times more in dialysis patients than in healthy individuals; however, the prevention and treatment of osteoporosis in pregnant dialysis patients have been difficult, since many osteoporosis medications are contraindicated in pregnant women and also their pregnancy period is not long due to the higher rate of preterm births.

Classifications in Brief: Garden Classification of Femoral Neck Fractures.

Classifications in Brief: Garden Classification of Femoral Neck Fractures.

Life style risk factors for femoral neck fracture in Dr. Sardjito General Hospital, Yogyakarta

As life expentancy improved, the incidence of femoral neck fracture, as one of the most common traumatic injuries in the elderly, has also increased. Risk for fracture is not only determined by age and sex but also by the degree of osteoporosis and certain life-styles. The purpose of this study was to investigate life-style risk factors for femoral neck fracture in Dr. Sardjito General Hospital, Yogyakarta. In this case-control study, all patients with femoral neck fractures admitted to the Orthopedic Division and Traumatology, Department of Surgery in 2013 – 2014 was included as cases. Controls were subjects without fracture of similar age and sex. Data of corticosteroid use, habitual coffee consumption, visual acuity disorders, habitual use of slippers and engagement in routine sport activity were collected with questionnaires. We invited 63 patients (51 females and 12 males) and 63 controls. Corticosteroid use, habitual coffee consumption, visual acuity disorder and habitual use of slippers were risks factors for fractures, OR (95% CI) = 7.5 (2.9- 21.6), p < 0.001; 7.5 (2.9-21.6), p < 0.001; 3.2 (1.6-6.8), p < 0.001 and 5.7 (2.7- 12.6), p < 0.001, respectively. Engagement in routine sport activity was a protecting factor, OR (95% CI) = 0.10 (0.02-0.33), p < 0.001. In conclusion, corticosteroid use, habitual coffee consumption, visual acuity disorder and habitual use of slippers are risk for fractures, while engagement in routine sport is a protecting factor

Does The Screw Orientation Effect s The Stability Of Femoral Neck Facture : A Finite Element Analysis

Objectives: The incidence of femoral neck fractures in younger-age people increases due to high-energy trauma. To avoid complications, stable internal fixation is essential. The most commonly used implants for vertically oriented femoral neck fractures are the cannulated and dynamic hip screws. In our study, we compared differently oriented cannulated screw configurations and a standard DHS for fixation of femoral neck fracture.Materials and Methods: A finite element-based collum femoris fracture was created and was fixed using four differently oriented triangular screw configurations and a dynamic hip screw. The loads were applied using a commercially available software package.Results: Centrally oriented cannulated screw configuration had the most compression and compression stress on the fracture side, and it had the highest stress values on the implant.Conclusion: We recommend the use of centrally oriented triangular cannulated screws for femoral neck fracture fixation. With this construct, more compression and compression pressure can be obtained, which can result in the early healing of the fracture. However, it must be kept in mind that this construct exerts more stress on the implant, which could be a reason for implant failure