전위성 대퇴경부 골절에 대한 금속나사 고정의 결과

Abstract

Purpose: This study retrospectively reviewed the results of a closed reduction and internal fixation with cannulated screws for a displaced femoral neck fracture. Materials and Methods: Among 631 patients between January 1991 and December 2000, 27 patients classified as Garden stage Ⅲ or Ⅳ were treated with a closed reduction and internal fixation with cannulated screws. The mean follow-up duration was 4.5 years. The mean age of the patients was 56.5 years. Results: Union and the restoration of function was observed in 15 cases (55.6%), and failure occurred in 12 cases (44.4%). The cause of failure was early stage reduction loss due to a failure to obtain anatomical reduction on the surgical field in 4 cases, reduction loss and displacement during the follow up period after an appropriate reduction at surgery in 4 cases and avascular necrosis in 4 cases. Seven cases were converted to a total hip arthroplasty, 4 cases were converted to bipolar hemiarthroplasty and 1 case is currently being followed up. Conclusion: A closed reduction and internal fixation for displaced femoral neck fracture showed a high failure rate. Therefore, an accurate anatomical reduction, firm internal fixation and efforts to prevent further unnecessary vascular injury will be needed to reduce the high failure rate and complications.