[Minimally invasive screw fixation of the intracapsular femoral neck fracture in elderly patients].
BACKGROUND
Increasing life expectancy is associated with an increase of geriatric fractures such as intracapsular femoral neck fractures. Their treatment by arthroplasty imposes a significant burden on our health care system.


METHODS
In an open clinical study we investigated the complication rate of a less expensive and less invasive, femoral head saving operative procedure. Between June 1997 and June 2000, 205 intracapsular femoral neck fractures of elderly patients (mean age 78.1 +/- 11.8 years) were fixed with cannulated screws.


RESULTS
Seventy-seven percent were displaced fractures and 15.6% were impacted Garden I fractures. Reoperation after internal fixation occurred in 38 patients. The most frequent cause of reoperation was secondary arthroplasty due to redisplacement (14x), femoral head necrosis (10x) and non-union (7x). Implant removal (4x), wound hematoma (1x) and femoral head penetration by screws (2x) were other causes for reoperation.


CONCLUSIONS
Less invasive cannulated screw fixation of intracapsular femoral neck fractures should be considered as a treatment option, because it is a smaller and less expensive operation than prosthetic replacement. Adequate reduction and screw placement, however, are a prerequisite for successful outcome.
Bosch
U
U
Unfallchirurgische Klinik der Medizinische Hochschule Hannover. bosch.ulrich@mh-hannover.de
Schreiber
T
T
Skutek
M
M
Cserháti
P
P
Fekete
K
K
Krettek
C
C
D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws / Q000191:economics; D017046:Cost Savings; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000191:economics; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D006814:Hungary; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery; D011859:Radiography; D012086:Reoperation
Die minimal-invasive Schraubenosteosynthese der medialen Schenkelhalsfraktur bei betagten Patienten.