title: Surgical Treatment of Undisplaced Femur Neck Fractures in Dementia Patients Using Proximal Femoral Nail Antirotation.
abstract: OBJECTIVE
  People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients.
  
  
  METHODS
  We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia. Patients were treated with PFNA and followed-up for more than 2 years. Revision, loss of fixation, complications, and walking ability outcomes were measured.
  
  
  RESULTS
  In walking-ability evaluation, patients showed an average decrease of just 0.2 points at the final follow-up. Walking ability was evaluated from before injury to 4 weeks after surgery and decreased by less than 0.5 points. Radiological bone union was achieved in 17 cases; the average time to bone union was 4.14 months (range, 2.5-7 months). Complications included non-union in two cases and femoral head avascular necrosis in one case of non-union.
  
  
  CONCLUSIONS
  We found that for patients with osteoporotic bone tissues in their femoral heads or patients (e.g., those suffering dementia) for whom cooperating with medical workers for postoperative walking control or rehabilitation exercises is difficult, implanting a mechanically stable spiral blade for fixation of femoral neck fractures could facilitate walking after surgery.
authors.affiliation: Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.
authors.forename: Bong-Ju
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.
authors.forename: Hong-Man
authors.initials: HM
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.
authors.forename: Woong-Bae
authors.initials: WB
authors.lastname: Min
keywords: Dementia; Proximal femoral nail antirotation; Undisplaced femoral neck fracture