THE RESULTS OF THE INTRACAPSULAR NECK FRACTURES OF THE FEMUR WITH THE POSTINJURY TIME MORE THAN 24 HOURS

Abstract

Objectives : To assess the results of our patients injured of intracapsular neck fracture of the femur osteosynthesed by cannulated screws; which could not have been operated within the ideal time because of various problems.

Materials & Methods: Fifty-two patients are accepted to the study from September 1991 to January 2008 which they had intracapsular neck fractures of femur caused by an injury and treated with the cannulated screws after 24 hours from the injury. Of the 52 patients, 22 were women (42,3%) and 30 were men (57,7%). The mean postinjury time of the patients was 125,6 (26–360) hours. Four patients had Garden type 1 (7,7%), 13 patients had Garden type 2 (25%), 24 patients had Garden type 3 (46,2%), and 11 patients had Garden type 4 (21,1%) intracapsular neck fractures. Fourty-two patients (80,8%) had gone to closed reduction, and 10 patients (19,2%) had gone to open reduction and they all were osteosynthesed with the cannulated screws. The reduction success is assessed by the x-rays. The mean follow-up time was 92,2 (15–179) months.

Results : The reduction success was moderate in 3 patients (5,8%), was good in 23 patients (44,2%), and was excellent in 26 patients (50%). There was no poor reduction success in any of the patients. The complications seen in the patients were; 6 AVN, 1 nonunion, 1 malunion, 2 reduction failure, 1 infection.

Conclusion : The patients with the intracapsular neck fractures of the femur could not have been operated within the ideal time because of life threatening poly-traumas, the late reference of patients to our clinic, and failing to establish ideal implant and operation circumstances in a timely manner. We believe that osteosynthesis with cannulated screw should not be discarded as a method of treatment even postinjury time exceeds 6 hours in intracapsular femoral neck fractures.