title: The perfect reduction: approaches and techniques.
abstract: Anatomic reduction of femoral neck fractures is difficult to obtain in a closed fashion. Open reduction provides for direct and controlled manipulation of fracture fragments. This can be accomplished via multiple approaches. The anterolateral, or Watson-Jones, approach or Smith-Petersen, or direct anterior, approach are the two most frequently used. Percutaneous techniques have also been described, though they lack the visual confirmation of reduction of a traditional open approach. These can be performed using a fracture table or with a free leg on a radiolucent table in either supine or lateral positions. Knowledge of the hip and pelvis anatomy is crucial for the preservation of critical femoral neck vasculature. Intra-operative fluoroscopy together with direct visualization provides the framework for successful manipulation of the fracture fragments, temporary stabilization, and ultimately fracture fixation.
authors.affiliation: Hennepin County Medical Center, Department of Orthopaedic Surgery, 701 Park Ave, G2.140, Minneapolis, MN 55415, United States. Electronic address: john.kurylo@gmail.com.
authors.forename: John C
authors.initials: JC
authors.lastname: Kurylo
authors.affiliation: Hennepin County Medical Center, Department of Orthopaedic Surgery, 701 Park Ave, G2.140, Minneapolis, MN 55415, United States; University of Minnesota, United States. Electronic address: templ015@umn.edu.
authors.forename: David
authors.initials: D
authors.lastname: Templeman
authors.affiliation: Hennepin County Medical Center, Department of Orthopaedic Surgery, 701 Park Ave, G2.140, Minneapolis, MN 55415, United States. Electronic address: gmirick@gmail.com.
authors.forename: Gudrun E
authors.initials: GE
authors.lastname: Mirick
mesh_terms: D005265:Femoral Neck Fractures / Q000601:surgery*; D005471:Fluoroscopy / Q000379:methods*; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D017410:Practice Guidelines as Topic; D016684:Prone Position; D016683:Supine Position; D016896:Treatment Outcome
keywords: Approach; Femoral neck fracture; Open reduction; Smith-Petersen; Watson-Jones