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Femoral Neck FractureAka: Intracapsular Hip Fracture, Subcapital Femur Fracture, Transcervical Femoral Neck Fracture

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  1. See Also
    1. Hip Fracture
  2. Pathophysiology
    1. Often results from minimal to no injury
  3. Risk Factors
    1. Osteoporosis
  4. Diagnosis
    1. See Hip Fracture
  5. Types: Garden Classification
    1. Non-displaced Fractures (20%)
      1. Type 1: Stress Fracture - Valgus impaction of head
      2. Type 2: Complete, non-displaced Fracture
    2. Displaced Fractures
      1. Type 3: Varus displacement of femoral head
      2. Type 4: Fracture fragments completely displaced
  6. Management
    1. Non-displaced Fracture (Type 1 or 2)
      1. Bone impaction provides Fracture stability
      2. Bedrest results in 90% union
      3. Open reduction and Internal Fixation: 100% union
    2. Displaced Fracture (Type 3 or 4)
      1. Open reduction and Internal Fixation
  7. Complications
    1. Non-union
    2. Avascular Necrosis
      1. Types 3 and 4 confer 10% risk
    3. Osteomyelitis or Septic Arthritis of the hip
      1. Reduced risk with perioperative antibiotics
    4. Pulmonary Embolism
      1. Leading cause of death at 7 days post-Fracture
  8. References
    1. Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60
    2. Schmidt (2002) Orthop Clin North Am 33(1):97

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