Assessment of Femoral Neck Fracture in Hemodialytic Patients.

In order to examine the pathogenesis and related problems of femoral neck fracture in hemodialytic patients, 16 patients with hemodialysis (HD) who were operated on for femoral neck fracture from November 1998 to December 2000 were reviewed. Average age at operation was 71 years and the average duration of HD was 17.4 years. Two out of the 16 cases had no obvious history of trauma. Thirteen cases had subcapital fracture and three cases had trochanteric fracture. All three cases with trochanteric fracture showed severe anemia and required blood transfusion before operation, whereas all cases of subcapital fracture did not. Subcapital fracture seemed more likely to occur in patients with HD presumably due to bone fragility and anatomical weakness of the femoral neck. In addition, appropriate volume control and early transufusion, when necessary, are considered very important for patients with HD, because they lack self-regulatory capacity.