Fractures of the femoral neck: some aspects of management in a fracture unit.

RESULTS During the eleven-year period 1957-1967, the case records of 495 patients with fracture of the femoral neck were available for study. There were 120 male and 376 female cases; one female patient had fractures of both femora at different times and therefore there were 496 fractures included in the series. The diagnosis was confirmed radiologically in all cases. Fig. 1 shows the age distribution of both male and female patients combined. Fig. 2 separates the sexes by age, revealing a distinctly different pattern. Fig. 3 shows the distribution of the patients by year of admission, the fracture unit having first opened in 1957. There were 242 cases with fractures of the right femur and 254 of the left femur. (This includes the patient with both hips fractured). Age and sex had no significant effect on which side was affected, except for females between 80 and 85 years when there were a third more right-sided fractures. Three hundred and eleven intracapsular fractures and 185 extracapsular fractures were recorded. Of the 496 fractures, 368 (74-19 per cent) were treated by open operation, and Table I shows the distribution of the types of initial treatment of the 495 patients. Intracapsular fractures were usually treated operatively either by Smith Petersen nailing (most frequently in the under-70 age group) or by femoral head replacement with the Austin Moore prosthesis (most frequently in the over-70 age group) as in Table IL. Blade plates were used in patients with extracapsular fractures. Patients unfit for operation were treated conservatively using Hamilton Russell type balanced traction. The complications were subdivided into local that is, related to the fracture and the technical procedure and general those related to other body systems. Details