Using biomechanics to improve the surgical technique for internal fixation of intracapsular femoral neck fractures.
Despite advances in science and technology, the success rate for the treatment of displaced intracapsular femoral neck fractures in high-energy injuries remains disappointing. The blood supply system in the femoral head of humans does not favor recovery from these fractures. Once these fractures occur, osteonecrosis and nonunion rates may be as high as 30%, even if the newest technique is used. There are some surgical techniques used to supplement internal fixation to reestablish the blood supply in the femoral head, but none have been evidently successful. After analysis of related studies, the author concludes that immediate surgical treatment using improved techniques incorporating the principles of biomechanics can improve the success rate of treatment of these fractures. Using these principles, the fracture site can achieve sufficient stability. Consequently, the blood supply in the femoral head and neck can be reestablished earlier and loss of reduction of fragments during treatment can be minimized. Thus, the chance of full recovery from these complicated fractures can be maximized. In this study, the biomechanical characteristics of these fractures and the principles associated with the surgical techniques used for treating them are reviewed and clarified. Finally, a surgical technique which is ideal from the author's viewpoint is presented. The author believes that the recommended surgical technique may become the best method for treating these complicated fractures.
Wu
Chi-Chuan
CC
Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan. ccwu@mail.cgu.edu.tw
D001696:Biomechanical Phenomena; D001863:Bone Screws; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000601:surgery*; D005270:Femur Head / Q000098:blood supply; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D013314:Stress, Mechanical