Management of femoral neck fractures in the young patient: A critical analysis review  

作　　者：Thierry Pauyo Justin Drager Anthony Albers Edward J Harvey 

机构地区：[1]Montreal General Hospital,Mc Gill University Health Center,Department of Orthopaedics,Montreal Quebec H3G1A4,Canada

出　　处：《World Journal of Orthopedics》2014年第3期204-217,共14页世界骨科杂志（英文版）

摘　　要：Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures.However for the physiologically young patients,preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands.The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures.Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population.Furthermore,other management variables such as surgical timing,the role of capsulotomy and the choice of implant for fixation remaincontroversial.This review will focus both on the demographics and injury profile of the young patient with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications.Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls. Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures. However for the physiologically young patients, preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands. The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures. Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population. Furthermore, other management variables such as surgical timing, the role of capsulotomy and the choice of implant for fixation remaincontroversial. This review will focus both on the demographics and injury profile of the young patient with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications.

关 键 词：OSTEONECROSIS FEMORAL NECK fracture Young patient CAPSULOTOMY SURGICAL TIMING 

分 类 号：R687.3[医药卫生—骨科学]