Plain radiograph (sensitivity 93-98%) is the first-line investigation for suspected NOF fractures. The mechanism in young patients is predominantly axial loading during high force trauma 9, with an abducted hip during injury causing a neck of femur fracture and an adducted hip causing a hip fracture-dislocation. There is generally deficient elastic resistance in the fractured bone 8. In elderly patients, the mechanism of injury varies from falls directly onto the hip to a twisting mechanism in which the patient’s foot is planted and the body rotates. motor vehicle collisions) in younger patients Subcapital fractures are graded by the Garden classification of hip fractures. While there is disagreement in the literature as to whether basicervical fractures are truly intracapsular or extracapsular, they should usually be treated like extracapsular fractures 14. Subcapital and transcervical fractures are considered intracapsular fractures. Transcervical: midportion of femoral neck Since disruption of blood supply to the femoral head is dependent on the type of fracture and causes significant morbidity, the diagnosis and classification of these fractures is important. Pathology Classificationįemoral neck fractures are a subset of proximal femoral fractures. The femoral neck is the weakest part of the femur. Hip fractures can be divided into intracapsular and extracapsular fractures with 60% being intracapsular and of that 80% are displaced 20. In patients aged between 65 and 99 years, femoral neck and intertrochanteric fractures occur with approximately the same frequency 7. The incidence of femoral neck fractures is increasing as the proportion of the elderly population in many countries increases 4.
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