FEMORAL-NECK FRACTURE FOLLOWING INTERTROCHANTERIC FRACTURE

Four patients with femoral neck fracture following healed intertrochan teric fracture were evaluated retrospectively. This situation is a rar e occurrence with a current literature review documenting only 15 case s. Patient charts and radiographs were retrospectively reviewed to eva luate the period from initial injury to definitive treatment for the f emoral neck fracture. Emphasis was placed on associated risk factors a nd operative techniques. In case 1, the femoral neck fracture appeared to be clearly a traumatic fracture as it occurred 11 years after the intertrochanteric fracture. In cases 2, 3, and 4, multiple factors wer e believed to play a role in the generation of the femoral neck fractu res, which occurred within 6 months of the original fracture. The etio logy of such fractures remains speculative. All four patients were eld erly, women with substantial medical comorbidities. Osteoporosis may b e the most important single contributing factor to these fractures. Be cause management of this patient subgroup is notably more complex, sur geons need to be aware of the difficulties and prepared to deal with t hem.