title: Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old.
abstract: BACKGROUND
  We retrospectively analyzed the clinical results of treatment of impacted or undisplaced femoral neck fractures (Garden types 1 and 2) by osteosynthesis in elderly patients >70-year old.
  
  
  METHODS
  We retrospectively reviewed the radiological results of 52 patients who were followed up for at least 6 months from April 2002 to December 2008. The average age of the patients was 77.6 years (range 70-97 years), and 38 patients were females. The mean follow-up period was 11.7 months (range 6-19 months). Thirteen cases were Garden type 1 fractures, and 39 were Garden type 2 fractures. We assessed the relationships between the occurrence of complications and age, sex, Garden stage, bone mineral density (BMD), history of contralateral hip fracture, and any additional hip injury.
  
  
  RESULTS
  Major complications occurred in 18 cases (34.6 %), including nonunion (8 cases), osteonecrosis (6 cases), stress fracture of the subtrochanter (2 cases), excessive pull-out of a screw (1 case), and deep infection (1 case). The development of complications was associated with Garden stage 2, BMD, and additional hip injury. However, other factors were not associated with complications. Reoperations were performed in 16 cases (30.1 %), and 2 of the patients died during follow-up.
  
  
  CONCLUSIONS
  A relatively high rate of complications or reoperations developed after treatment of Garden 2 femoral neck fractures in senile patients >70 years of age with osteoporosis. Although internal fixation has been recommended in the literature for undisplaced femoral neck fractures, primary arthroplasty may be a better option for treatment of Garden type 2 fractures in elderly patients.
authors.affiliation: Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Dongdaemun-gu, Seoul, 130-709, Republic of Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Dongdaemun-gu, Seoul, 130-709, Republic of Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Song
authors.affiliation: Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Dongdaemun-gu, Seoul, 130-709, Republic of Korea.
authors.forename: R
authors.initials: R
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Dongdaemun-gu, Seoul, 130-709, Republic of Korea. gamjang@medimail.co.kr.
authors.forename: S H
authors.initials: SH
authors.lastname: Kang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D015519:Bone Density; D001863:Bone Screws / Q000009:adverse effects*; D057186:Comparative Effectiveness Research; D005260:Female; D005265:Femoral Neck Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D010020:Osteonecrosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography / Q000379:methods; D012086:Reoperation; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: Elderly; Femoral neck fracture; Garden type 1 and 2