This post is also available in: English Slovenščina (Slovenian)

Intracapsular fractures of the femoral neck may considerably deteriorate the quality of life of elderly. The specific structure and blood supply to the uper part of the femur contribute to complications, especially aseptic head necrosis and pseudarthrosis (nonunion), which frequently occur in the course of treatment. We examined medical records, follow-up results and radiographs of 197 patients (134 women and 63 men) with fracture of the femoral neck, treated at Univer. traum. dept. in 1987. The average age of the patients was 72 years (range 22 – 94 years). Fractures were most frequently caused by a simple fall. The type of fracture was determined according to the Pauwels and Garden classification. In 41 patients, the fracture was treated conservatively and in the rest operatively. The technique most frequently used in our series was internal fixation with a 130° – blade plate, which was accomplished in 123 patients. 15 patients died in the hospital, and 47 were lost to follow-up. Of the 135 patients followed, 23 had primarily implanted endoprothesis. Avascular necrosis of the head developed in 19 of the 112 patients (17%). Nonunion occured in 7 cases (6.2%). Both complications were dependent on the type of the fracture. Our results indicate that, in addition to accurate reduction, adequate impaction of fragments and correct internal fixation, the time of the operation is a very important factor in these fractures. The rate of avascular head necrosis after early operations was significantly lower (p < 0.05) than following late surgery. ln 75.9% of the patients attending for follow-up examinations, clinical results were rated as satisfactory, good or very good.