الفهرس | Only 14 pages are availabe for public view |
Abstract our study included one hundred fourty nine patients with femoral neck fractures treated in Orthopaedic and Traumatology depatments of both Mansoura University Hospital (Egypt) and Regensturg University Hospital (Germany). The fractures were recent, non pathologic and the patients were ambulant withoutwalking aids before their injury. The patients were adult persons of both sex between the ages of 20-60 years. Both intracapsular and extracapsular fractures wether displaced or undisplaced were included in this series. The intracapsular fractures were classified using Garden’s classification into four grades (Garden I, II, III and IV) while the extracapsular fractures were classified into displaced and undisplaced basal neck fractures. the undisplaced intracapsular fractures including Garden I and Garden II fractures as well as undisplaced basal neck fractures were treated by pinning insitu using three cancellous screws. The displaced intracapsular fractures including Garden 11 and Garden IV as well as the displaced basal neck fractures were reduced and randomly treated with either three cancellous screws or with 135 degrees dynamic hip scew (DHS). Accordingly, the patients with femoral neck fractures included in this study were classified into three groups: • Group A: This group included the undisplaced intracapsular and basal neck fractures which were treated by pinning insitu using three cancellous screws. • Group B: This group included the displaced intracapsular and basal neck fractures which were treated by reduction and internal fixation using three cancellous screws. • Group C: This group included the displaced intracapsular and basal neck fractures which were treated by reduction and internal fixation using 135 degrees DHS. In every patient the fracture of the femoral neck was properly evaluated regarding the site of the fracture, fracture grade, bone quality and the presence or absence of any comminution of the posterior cortex of the femoral neck, this was done with the help of both anteroposterior and lateral radiographs. Although in this study we planned to operate these fractures as early as possible but some fractures have been done after 24 hours. General anaesthesia was commonly used (62.4%) in our study, while spinal anaesthesia was used in the rest of the patients (37.6%). |