S. Lindequist et H. Tornkvist, QUALITY OF REDUCTION AND CORTICAL SCREW SUPPORT IN FEMORAL-NECK FRACTURES - AN ANALYSIS OF 72 FRACTURES WITH A NEW COMPUTERIZED MEASURING METHOD, Journal of orthopaedic trauma, 9(3), 1995, pp. 215-221
The aim of this study was to compare the quality of reduction and the
position of the fixating screws with the rate of union in 72 femoral n
eck fractures. The degree of fracture displacement after reduction and
the position of the two fixating screws were determined with a new co
mputerized measuring method that compensates for the variations in hip
rotation in routine radiographs. All 13 nondisplaced fractures united
. Sixteen of 18 fractures healed in the group of displaced fractures w
here both the fixating screws were placed within 3 mm from the femoral
neck cortex, compared with 13 of 22 healed fractures in the group whe
re only one screw had the same close contact with the femoral neck cor
tex (p < 0.05). Nonunion developed in ah five displaced fractures wher
e none of the two fixating screws were placed within 3 mm from the fem
oral neck cortex. The quality of reduction did not affect the healing
rate; however, the number of poorly reduced fractures was only 10%. Th
e results of this study underline the importance of achieving cortical
support for the fixating screws in femoral neck fracture surgery.