Vertical Femoral Neck Fractures in Young Adult Patients

Radiological and Functional Outcomes of Internal Fixation Methods for Vertical Femoral Neck Fractures in Young Adult Patients

Does the current techniques of internal fixation of vertical neck fracture in young adult patients give a satisfactory radiological and functional outcome at one year follow up?

• Displaced femoral neck fractures in young adults are most likely to result from high energy trauma that causes a vertically-oriented shearing injury through the femoral neck.
• The most descriptive classification used for femoral neck fractures in young patients is the Pauwels classification. As the degree of the femoral neck fracture line relative to the horizontal plane increases, the types differ (30 degrees type I, between 30 degrees and 50 degrees type II, 50 degrees type III), and the instability of the fracture.
• Greater fracture verticality contributes to greater difficulty in obtaining adequate stability to resist vertical shear forces around the hip, thereby resulting in ascending greater risk of complications such as nonunion and osteonecrosis despite a number of potential fixation strategies.
• The primary goals of surgery include preservation of the femoral head, avoidance of osteonecrosis, and achievement of a stable union.
• Fixation options include cannulated screws, sliding hip screw with or without an additional derotation screw,. among orthopedic trauma surgeons there is no consensus that a single fixation Option is superior for treating these injuries.

Inclusion Criteria:

• Age of the patients from 20 to 50 years

  • Pauwel type III fractures
  • Recent fracture within one week

Exclusion Criteria:

• • Open fractures

  • Pathological or osteoporotic fractures.
  • Patient with comorbidities: D.M, renal patient, neurological deficits.
  • Patient associated with femoral head fractures or head impaction.