Orthopedics Book

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Femoral Neck Fracture

Aka: Femoral Neck Fracture, Intracapsular Hip Fracture, Subcapital Femur Fracture, Transcervical Femoral Neck Fracture
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  1. See Also
    1. Hip Fracture
    2. Femoral Shaft Fracture
  2. Pathophysiology
    1. Often results from minimal to no injury
  3. Risk Factors
    1. Osteoporosis
  4. Diagnosis
    1. See Hip Fracture
  5. Types: Garden Classification
    1. Non-displaced Fractures (20%)
      1. Type 1: Stress Fracture - Valgus impaction of head
      2. Type 2: Complete, non-displaced Fracture
    2. Displaced Fractures
      1. Type 3: Varus displacement of femoral head
      2. Type 4: Fracture fragments completely displaced
  6. Management
    1. Non-displaced Fracture (Type 1 or 2)
      1. Bone impaction provides Fracture stability
      2. Bedrest results in 90% union
      3. Open reduction and Internal Fixation: 100% union
    2. Displaced Fracture (Type 3 or 4)
      1. Open reduction and Internal Fixation
  7. Complications
    1. Non-union
    2. Avascular Necrosis
      1. Types 3 and 4 confer 10% risk
    3. Osteomyelitis or Septic Arthritis of the hip
      1. Reduced risk with perioperative antibiotics
    4. Pulmonary Embolism
      1. Leading cause of death at 7 days post-Fracture
  8. References
    1. Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60
    2. Schmidt (2002) Orthop Clin North Am 33(1):97-111

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