[The minimally-invasive screw osteosynthesis of the medial femoral neck fracture in the very old. A prospective clinical study].
Increasing life expectancy has led to an increase of medial femoral neck fractures. Treatment by hip arthroplasty is a major surgical procedure for geriatric patients and imposes high healthcare costs. Manninger developed a cannulated screw system which allows a joint-sparing, less invasive, and stable internal fixation for the management of intracapsular femoral neck fractures. In a prospective study from January 1998 to August 2002, 63 patients older than 70 years with Garden type I to III fractures were treated by closed reduction and internal fixation with two Manninger screws on a traction table within the first 6 h after trauma. Mean time of follow-up was 21.5+/-16 months. Of the patients examined, 88.5% regained their preoperative stage of mobility. Two patients needed secondary hip arthroplasty. Due to low complication and failure rates and less medical expenses compared to treatment by hemiprosthesis the joint-sparing, less invasive internal fixation with two cannulated Manninger screws presents a safe and cost-efficient surgical technique for geriatric patients.
Galla
M
M
Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung Hannover.
Lobenhoffer
P
P
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005853:Geriatrics / Q000295:instrumentation / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome