Internal fixation of femoral neck fractures - An Atlas

CONTENTS

PREFACE TO THE ENGLISH EDITION

PREFACE TO THE GERMAN EDITION

FOREWORD TO THE GERMAN EDITION

FOREWORD TO THE FIRST HUNGARIAN EDITION

Chapter 1 PROXIMAL FEMUR FRACTURES. DEFINITION, EPIDEMIOLOGY, ANATOMY, BIOMECHANICS

1.1 Introduction

1.2 Definition and frequency of hip fractures

1.3 Topographic and surgical anatomy

1.4 Correlation between osteoporosis, age and sex for hip fractures

1.5 Selected biomechanical characteristics of the proximal femur

1.6 The blood supply to the proximal femur

Chapter 2 PATHOLOGY OF FEMORAL NECK FRACTURES

2.1 General pathology

2.2 Stress- and spontaneous fractures of the femoral neck

2.3 The pathologic neck fracture

2.4 Circulatory disturbances

2.5 The intraosseous femoral head drainage

2.6 Types of femoral neck fractures

2.7 Grouping of fractures: Pauwels-, Garden-and AO- classification

2.8 The undisplaced neck fracture ( Garden- I and - II)

Chapter 3 DIAGNOSTIC INVESTIGATIONS

3.1 History and physical examination

3.2 Radiographic investigation. Special imaging procedures

3.3 Examination of the circulation in the femoral head ( intraosseous venography)

3.4 Diagnostic problems (recommendations how to avoid mistakes and errors)

Chapter 4 HISTORICAL RETROSPECTION

4.1 History of the treatment of hip fractures

4.2 The stages of development of internal fixation for femoral neck fractures at the National Institute of Traumatology ( Budapest)

Chapter 5 BIOMECHANICAL ASPECTS OF CANNULATED SCREW FIXATION. EXPERIMENTAL INVESTIGATIONS AND DEVELOPMENTS

5.1 The importance of three-point buttressing

5.2 Reinforcement of the first point of buttressing – improvement of the purchase in the femoral head

5.3 Reinforcement of the second buttressing point: Adam’s arch and calcar femorale

5.4 Reinforcement of the third buttressing point – lateral cortex

5.5 Importance of the loss of reduction in rotation and possibilities to avoid it

5.6 Settling of the fracture leading to shortening of the femoral neck

5.7 Recent improvements and concepts for the future

Chapter 6 JUSTIFICATION FOR EARLY SURGERY

6.1 Timing for internal fixation of hip fractures

6.2 The progress of emergency surgery in Hungary

6.3 Determination of the optimal moment of surgery – summary of investigations performed in Budapest

6.4 Guaranteeing the prerequisites for an immediate surgery

6.5 Present treatment methods at the National Institute of Traumatology ( Budapest)

6.6 General condition and co-morbidity of the elderly accident victim

Chapter 7 REDUCTION OF THE FRACTURE

7.1 Introduction

7.2 Closed reduction of displaced neck fractures

7.3 Open reduction of a displaced neck fracture

7.4 Reduction of a Garden-I fracture impacted in hypervalgus

7.5 Frequent errors of reduction

7.6 Guidelines for the assessment of reduction

Chapter 8 INTERNAL FIXATION

8.1 Preparation for surgery

8.2 Implants and instruments for cannulated screw fixation of neck fractures

8.3 Technique of percutaneous screw fixation of neck fractures

8.4 Guidelines for the assessment of internal fixation

8.5 Internal screw fixation with exposure of the femur

8.6 Technique to increase the stability of internal fixation

Chapter 9 TREATMENT OF UNDISPLACED AND ATYPICAL FEMORAL NECK FRACTURES

9.1 Treatment of undisplaced femoral neck fractures ( Garden- I and - II)

9.2 Femoral neck fractures in young adults ( 20– 50 years- old)

9.3 Femoral neck fractures in children and adolescents

9.4 Treatment of stress fractures of the femoral neck

9.5 Treatment of pathologic femoral neck fractures

Chapter 10 POSTOPERATIVE TREATMENT, EARLY COMPLICATIONS

10.1 Early postoperative treatment and prob-lems encountered during this period

10.2 Early complications of the surgical wound

10.3 Mobilization, follow-up care

10.4 Local mechanical complications after internal fixation with cannulated screws and their treatment

Chapter 11 TREATMENT RESULTS

11.1 Introduction

11.2 Comparison between Smith-Petersen nailing and cannulated screw fixation

11.3 Score results of the analysis of reduction and internal fixation

11.4 Analysis of the causes for loss of reduction

11.5 Cannulated screw fixation 1993–94 in comparison with 1997– 98

11.6 Treatment of femoral neck fractures – internal fixation versus joint replacement

Chapter 12 APPENDIX

12.1 Definition of terms particular to the subject of internal fixation of femoral neck fractures

12.2 Members in charge of the research team “ Femoral Neck Fractures” at the National Institute of Traumatology ( Budapest)

12.3 Foreign teachers, councilors and supporters

REFERENCES

SUBJECT INDEX

AUTHORS’ INDEX