Internal fixation and avascular necrosis of the femoral head after fracture - open or closed reduction?
Avascular necrosis (AN) of the femoral head is a frequent compication after operation of femoral neck fracture with internal fixation. In a retrospecitve study we folowed development of AN in 60 operated patients and compared the results of treatment with open or closed reduction. All the patients had intracapsular fracture of the femoral neck, were aged to 65 years and operated with a 130 degree plate. Thirty patients were operated with open reduction (Group A), and thirty patients with closed reduction, X-ray (Group B). In a three-year follow-up sixteen (26.6 per cent) of sixty operated patients developed An. In Group A nine (30.0 per cent) patients developed AN, while in group B seven (23.3 per cent). The frequency of AN development was lower (6.7 per cent) with closed reduction. We can conclude that higher incidence of AN after open reduction is the consequence of greater operational trauma and additional damage of circulation.
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