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

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

• Clinical Pain
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• v.18 no.2
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• pp.126-129
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• 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 Yeungnam Medical Science
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• v.40 no.2
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• pp.212-217
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• 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 radiological science and technology
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• v.23 no.2
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• pp.13-19
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• 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
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• v.31 no.3
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• pp.181-188
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• 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.

• Journal of agricultural medicine and community health
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• v.48 no.4
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• pp.275-284
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• 2023

Objectives: This study aimed to assess hand grip strength and femoral neck bone mineral density levels among Korean fishery workers and investigate their association. Methods: Hand grip strength and femoral neck bone mineral density were measured in a survey and health examination conducted in 2021 among fishery workers in a southern region of South Korea. Covariates including gender, age, education level, income level, smoking behavior, drinking behavior, family history of hip fractures, use of calcium and vitamin D supplements, hypertension, diabetes, regular exercise, and body mass index were investigated. Multiple regression analysis was employed to assess the association between hand grip strength and femoral neck bone mineral density. Results: Among 147 fishery workers, 8.16% exhibited low hand grip strength levels indicative of possible sarcopenia, and a significant association was found between low hand grip strength and decreased femoral neck bone mineral density (β = -89.14, 95% CI = -160.50, -17.78). Additionally, factors such as women gender, advanced age, family history of hip fractures, and a body mass index below 25 kg/m² were associated with decreased femoral neck bone mineral density. In the subgroup analysis by gender, a correlation between low hand grip strength and decreased femoral neck bone mineral density was observed only in men. Conclusions: Further research is needed to explore various determinants and intervention strategies to prevent musculoskeletal disorders among fishery workers, ultimately enhancing their quality of life and well-being.

• Journal of the Korean Society for Nondestructive Testing
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• v.31 no.5
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• pp.459-465
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• 2011

It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.17-22
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• 1988

Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents(5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture(6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

• Hip & pelvis
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• v.35 no.3
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• pp.157-163
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• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.