1. A review of 195 patients with displaced intracapsular fractures of the femoral neck treated by a sliding nail-plate appliance has been presented. 2. The highest failure rate was evident in fractures in women over seventy-five with Grade 4 displacement. 3. The effect of various concomitant factors has been analysed in relation to the end results. 4. Observations have been made on avascular necrosis, its incidence amongst the failures and its association with late segmental collapse after fracture union.
1 . A preliminary report is presented of a clinical trial to compare the results of early and late weight bearing in randomly selected patients of comparable age groups whose displaced femoral neck fractures were treated by internal fixation with a sliding nail-plate. 2. When 124 patients were assessed at three months and 107 at six months after operation there was no significant difference between those who started unguarded weight bearing two weeks after operation and those who avoided weight bearing for three months. 3. Early weight bearing appears to have no harmful effect on the early post-operative stability of this fracture when a sliding nail-plate is used for fixation. 4. Further information is necessary before any conclusion can be reached about the effect of early weight bearing on the ultimate fate of the fracture and of the femoral head. For this reason, and also to increase the numbers of patients in the series, the trial is continuing and the patients are being followed up for a three-year period.
1. It is now more than three years since a group of ninety-one patients with transcervical fracture of the neck of the femur were examined for osteoporosis at the time of injury using a histological or a radiographic technique, or a combination of both methods. 2. After patients with basal fractures were excluded, ninety fractures in eighty-eight patients were available for review and sixty-six (74 per cent) were adequately followed up. 3. In this series the fate of the fracture did not appear to be influenced by the presence or absence of osteoporosis, or by the degree of osteoporosis. 4. The incidence of osteoporosis increased with advancing age, but this increased incidence did not appear to be responsible for the greater proportion of failures after the age of sixty-five. 5. In this series of patients examination for osteoporosis was made by methods which were believed to be the best available at the time. The possibility that these are not absolutely reliable cannot be ruled out.
