Internal fixation and avascular necrosis of the femoral head after fracture - open or closed reduction?

  • Franjo Husinec General Hospital "Dr. Tomislav Bardek", Koprivnica, Croatia
  • Bozidar Zupancic Children's Hospital Zagreb, Zagreb, Croatia
  • Wajih Hammoud General Hospital "Dr. Tomislav Bardek", Koprivnica, Croatia
Keywords: avascular necrosis (AN), fracture of the femoral neck, internal fixation

Abstract

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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References

Aitken JM, Relevance of osteoporosis in women with fracture of the femoral neck. Br Med J 1984; 288-97

Alffram PA. An epidemiologic study of cervical and trochanteric fractures of the femur in an urban population. Acta Orthop Scand 1964; 65: I

Baixauli EJ, Baixauli F jr, Lozano JA. Avascular necrosis of the femoral head after intertrochanteric fractures. J Orthop Trauma 1999; 13(1):9-12

Bochner RM, Oellici PM, Lynden JP. Bipolar hemiarthroplasty for fracture of femoral neck. J Bone Joint Surg 1988; 70-A: 1001-10

FogeIman l. Bone scanning in clinical practice. Berlin: Springer Verlag; 1987.

Grazio S, Koršić M. Unos dijetalnog kalcija i prevalencija deformacija kralješaka u uzorku starije populacije. Liječ Vjesn 2003; 125: 117-24

Hogh J, Jensen J, Lauritizen J. Dislocated femoral neck fractures. Acta Orthop Scand 1982; 53: 245-9

Husinec F. Femoral head collapse in early X-ray diagnosis of posttraumatic necrosis. Acta Orthop Iugosl 1990; 20: 49-55

Koval KJ, Zukerman JO. Hip fractures - a practical guide to management. Berlin Heidelberg New York: Springer; 2000.

Kregor PJ. The effect of femoral neck fractures on femoral head blood flow. Orthopedics 1996; 19(12): 1031-6

Kyle RF, Cabanel a ME, Russell TA et al. Fractures of the proximal part of the femur. J Bone Joint Surg 1994; 76: 924-50

Linde F, Andersen E, Hvass l et al. Avascular femoral head necrosis following fracture fixation. Injury 1986; 17(3): 159-63

Malhotra R, Arya R, Bhan S. Bipolar hemiarthroplasty in femoral neck fractures. Arch Orthop Trauma Surg 1995; 114:7 9-82

Maričević A, Erceg M, Gekić K. Liječenje prijeloma vrata bi polarnom hemiartroplastikom. Liječ Vjesn 1998; 120: 121-4

Matković V. Osteoporoza i frakture u Hrvatskoj. Liječ Vjesn 1981; 103: 348-51

Matković V. Utjecaj dobi, spola i prehrane na gubitak koštanog tkiva. Disertacija; Sveučilište u Zagrebu, Zagreb, 1976.

Melton LJ, Thamer M, Ray NF et al. Fracture attributable to osteoporosis: Report from the National Osteoporosis Foundation. J Bone Mineral Res 1997; 12: 16-23

Nagi ON, Dhillon MS, Goni VG. Open reduction, internal fixation and fibular autografting for neglected fracture of the femoral neck. J Bone Joint Surg 1998; 80B(5): 798-804

National Osteoporosis Foundation. Osteoporisis Int 1998; 4 Suppl.: 7-80

Steinberg ME. Avascular necrosis of the femoral head. in: Tronzo RG. Surgery of the hip joint. Stuttgart: Springer; 1987. 1-29

Strömqvist B, Hansson Ll. Femoral head vitality after femoral neck fracture-comparison between pre- and postoperative tetracycline labeling. Acta Orthop Scand. 1984; Suppl. I

Strömqvist B. Femoral head vitality after intracapsular hip fracture. Acta Orthop Scand 1983; 54 Suppl. 200: 7-71

Tomek-Roksandić S, Vorko-Jović A. Aktualnost obiteljske medicine u zaštiti zdravlja starih ljudi. Liječ Vjesn 1994; 116: 251-4

Vanvugt AB, Oosterwijk WM, Goris RJA. Predective value of early scintimetry in intracapsular hip fractures prospective study with regard to femoral head necrosis, delayed union and nonunion. Archives of Orthopedic and Trauma Surgery 1993; 113(1): 33-8

Published
2004-12-01
How to Cite
1.
Husinec F, Zupancic B, Hammoud W. Internal fixation and avascular necrosis of the femoral head after fracture - open or closed reduction?. Acta Chir. Croat. [Internet]. 2004Dec.1 [cited 2022Jan.16];1(1):45-8. Available from: https://acc.hkd.com.hr/index.php/ACC/article/view/52
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