Minimalinvasive nthese der medialen Schenkelhals- fraktur bei betagten Patienten

Abstract Increasing life expectancy is associated withincreasing numbers of geriatric fractures,such as intracapsular femoral neck fractures.Treating all these by arthroplasty puts a sig-nificant financial burden on our health caresystem.In an open clinical study we investi-gated the frequency of complications andtheir type following a less expensive and lessinvasive procedure that conserves the fem-oral head.Between June 1997 and June2000,205 intracapsular femoral neck frac-tures (77% displaced fractures and 15.6%were Tyimpacted Garden I fractures) in elderlypatients (mean age 78.1±11.8 years) werefixed with cannulated screws.Revision oper-ations were necessary after the internal fixa-tion in 38 patients.The most frequent goal ofrevision surgery was secondary arthroplasty,necessitated by redislocation (14 cases),femoral head necrosis (10 cases) or non-union (7 cases).Other reasons for revisionoperations were implant removal (4 cases),wound hematoma (1) and femoral headpenetration by the screws (2).Minimally in-vasive cannulated screw fixation should beconsidered as a treatment option for intra-capsular femoral neck fractures in elderly patients,because it is a less elaborate andless expensive operation than prosthetic re-placement.It cannot,however,be successfulwithout adequate reduction and screwplacement.