• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.6 no.2
• /
• pp.79-85
• /
• 2011

Objectives : The Purpose of this study is to investigate the clinical application of conservative treatment for femoral neck stress fracture developed in avascular necrosis of the femoral head. Methods : Patient is hospitalized at Dept. of Oriental Rehabilitation Medicine, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as femoral neck stress fracture developed in avascular necrosis of the femoral head and treated by herbal medicine, acupuncture and moxibustion. This study was measured by Visual Analogue Scale(VAS) score, range of motion and walking time. Results : After conservative treatment, the patient's pain was controlled and VAS score was decreased. Range of motion and walking time were improved. Conclusions : As seen in this one case, Oriental conservative treatment has a positive effect to control pain with femoral neck stress fracture developed in avascular necrosis of the femoral head.

• Journal of Yeungnam Medical Science
• /
• v.40 no.2
• /
• pp.212-217
• /
• 2023

We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

• Journal of Acupuncture Research
• /
• v.30 no.5
• /
• pp.175-183
• /
• 2013

Objjectives : The purpose on this report is to show the clinical efficacy of korean medical treatments for femoral neck fracture treated non-operatively. Methods : The patient with femoral neck fracture was treated using acupuncture, herbal medication, And the efficacy of treatment had been measured in visual analog scale(VAS) scores and Harris hip scores(HHS) per one month for seven months. Results : After treatment, HHS score had been increased from 0 to 74 and VAS of femoral pain had been decreased form 10 to 1.5. Conclusions : From the above results, It is demonstrated that korean medical treatments is effective on patient with femoral neck fracture treated non-operatively.

• Journal of radiological science and technology
• /
• v.23 no.2
• /
• pp.13-19
• /
• 2000

There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and Febuary in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry(DEXA). The result was compared using age matched paired T test. The results were as follows ; 1. The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. 2. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. 3. The bone density of neck, Ward's triangle, trochanter(P<0.05) and lumbar spine(P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. 4. The bone density of neck, Ward's triangle, trochanter(P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. 5. The bone density of neck, Ward's triangle, trochanter and lumbar spine(P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities(BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.

• Journal of Trauma and Injury
• /
• v.31 no.3
• /
• pp.181-188
• /
• 2018

Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.

• Clinical Pain
• /
• v.18 no.2
• /
• pp.126-129
• /
• 2019

Bilateral femoral neck stress fractures have been rarely reported. When diagnosed, they are usually limited to athletes or military personnel. A 35-year-old man, previously healthy, visited the emergency department for right inguinal pain. On physical examination, no external wound, tenderness or limitation of motion were found in either lower extremity. Plain radiography showed normal findings but an magnetic resonance image showed a linear fracture in the femoral neck. In this case, bilateral femoral neck stress fractures were found in a young non-athlete adult with no prior medical history of related injuries. Surgery is generally not performed for stress fractures but considering the patient's early mobilization and the need for quick reintegration into society, surgery was done in this case.

• Journal of Acupuncture Research
• /
• v.35 no.4
• /
• pp.252-258
• /
• 2018

This report showed the clinical outcome of an elderly patient with a femoral neck fracture who was treated non-operatively with Korean medical treatment. The patient had acupuncture, herbal medication, moxibustion, and participated in physical rehabilitation for 3 months. The effects of Korean medical treatment were measured every 2 weeks using the numeric rating scale (NRS) and the Harris hip score (HHS). After treatments, the NRS score for hip pain decreased from 8 to 2, and the HHS increased from 0 to 43. A 42-month follow-up showed the patient's NRS score was 0 and the HHS was 61. Furthermore, an X-ray showed complete union of the femoral neck fracture with no suspicion of avascular necrosis. These results suggest that Korean medical treatment can effectively reduce pain and aid rehabilitation in patient with femoral neck fractures with no surgery, resulting in complete union of the fracture.

• Hip & pelvis
• /
• v.35 no.1
• /
• pp.47-53
• /
• 2023

Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures. Materials and Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated. Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation. Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

• Journal of Trauma and Injury
• /
• v.31 no.2
• /
• pp.96-102
• /
• 2018

Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

• Hip & pelvis
• /
• v.35 no.4
• /
• pp.259-267
• /
• 2023

Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.