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Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

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.

Materials and 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.

Conclusion

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.

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Conflict of interest

Hyun Seok Song, Suk Ku Han, Ryul Kim, and Soo Hwan Kang declare that they have no conflict of interest.

Ethical standard

All authors obey the rules of Helsinki Declaration and no ethic problem exists in the manuscript. This study was approved by the institutional review board.

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Correspondence to S. H. Kang.

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Han, S.K., Song, H.S., Kim, R. et al. Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old. Eur J Trauma Emerg Surg 42, 191–196 (2016). https://doi.org/10.1007/s00068-015-0528-6

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  • DOI: https://doi.org/10.1007/s00068-015-0528-6

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