Abstract
The results of osteosynthesis for intracapusular fracture of the femoral neck with cannulated screws in 85 patients (21 men, 64 women) between January 2000 and May 2005 were reviewed retrospectively. Thirty-two patients had a non-displaced fracture and 53 patients had a displaced fracture. The mean age of the patients at the time of the operation was 70 years (range, 38 to 93 years). The patients were followed radiographically and clinically for mean period of 19.3 months (range, 6 to 60 months) excluding patients who underwent second operation. There were 11 cases of non-union, all of which were displaced fractures. The non-union rate was 21% in displaced fractures. Late segmental collapse (LSC) occurred in 4 patients, three of whom had a displaced fracture and one had a non-displaced fracture. The LSC rate was 4.7%.
Fifty-nine non-union cases (13 men, 46 women) were evaluated using magnetic resonance imaging (MRI). The mean age of the patients at the time of the operation was 67 years (range, 38 to 92 years). The mean period of follow-up was 21 months. (range, 6 to 60 months) About 3 months after operation 32 of 59 patients (54%) showed a band of low signal intensity on T1-weighted images indicating osteonecrosis in the femoral head. We classified it into 2 types: Type I (large type) lesion was over half of the weight bearing the region of the femoral head, and type II (small type) was less than half the region. There were 21 patients (36%) with type I signals and 11 patients with type II (19%). All of the cases of collapse of the femoral head occurred in 4 patients with type I signals.
Although we are relatively satisfied with the clinical outcomes, it is necessary to continue to follow the 21 patients with osteonecrosis of the femoral head.
