Medullary Index Research Articles

The Operative Treatment of Collum Femoris Fractures

The author presents a method of treatment which he has found successful. Of a series of 3,635 patients admitted with a total of 3,940 fractures and dislocations, 390, or about 10 per cent, had fractures of the neck of the femur. Seventy-five per cent of the patients were over 60 years of age. The author quotes Radasch, who described the "medullary index": that is, the relation between the compacta and the bone marrow changes with increasing age, the medullary cavity growing wider while the cortex becomes thinner. He emphasizes the importance of taking roentgenograms, not only in the ventral-dorsal but also in the lateral projection. He advises an additional lateral roentgenogram of the unaffected hip. Johansson believes that interposition of tissue delays but does not necessarily prevent complete osseous union. In his 390 cases there was a primary mortality of about 14 per cent. He states that the so-called Whitman