title: Femoral neck fractures in older patients: indication for osteosynthesis.
abstract: In almost all the patients over 65 years of age with intracapsular femoral neck fractures who we treated over a 2-year period, we used osteosynthesis with Ace 6.5-mm cannulated cancellous screws. We then followed them for at least 24 months. Each of the seven nondisplaced fractures healed. Of the 20 displaced fractures, 14 were rated as healed, 5 as failures, and 1 as a late segmental collapse. Among the 14 displaced fractures with an operative delay of 1 day, 12 healed, whereas only 2 of the 6 fractures with an operative delay of 2 days or more did so. Of the 12 typical fractures (with a medial spike in the head fragment), 10 healed, as did 4 of the 8 crescent or mixed-type fractures. The treatment of choice for nondisplaced fractures is osteosynthesis. Displaced fractures that occur on the day of operation or the day before should be treated with osteosynthesis if they are the typical type. The rest of the displaced fractures should be considered candidates for primary prosthetic replacement.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Prefectural Aki Hospital, 1-32 Hoei-cho, Aki 784-0027, Japan.
authors.forename: Eichi
authors.initials: E
authors.lastname: Itadera
authors.forename: Norikazu
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Norio
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Takao
authors.initials: T
authors.lastname: Ohmori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashizume
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D011446:Prospective Studies