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Femoral neck fractures (Background (Risk factors: increased age, women,…
Femoral neck fractures
Background
Risk factors: increased age, women
Mechanism: high energy impact in young patients, low energy falls in elderly patients
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Prognosis
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Complications: osteonecrosis (10-45%), non-union (5-30%), dislocation (10%), failure of fixation
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Classification
Garden
Type 1: Incomplete, i.e. valgus impacted
Type 2: complete #, non displaced
Type 3: complete #, partially displaced
Type 4: complete, fully displaced
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Clinical presentation
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Impacted or stress fracutre: minor discomfort with ROM, muscle spasms and pain with percussion of greater trochanter
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Imaging
X-rays: AP pelvis (traction + internal rotation best way to determine type of #), lateral pelvis, full length femur
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Management
Operative
Options: ORIF, cannulated screw fixation, sliding hip screw, hemiarthroplasty, THR
Non-operative:
Indications: elderly, minimal pain
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