Abstract

DEMOGRAPHIC AND CLINICAL ANALYSIS OF FRACTURE NECK OF FEMUR

Author(s): Manoj Kumar Gudluru, Naresh Eamani

Longest bone of human body is femur, which by itself forms the skeleton of the thigh. It is composed of body, upper extremity and lower extremity. The upper extremity is made up of a head, a neck and two shafts called ‘the greater’ and ‘the lesser’ trochanter. Surgical neck of femur connects upper extremity to body. Fracture neck of femur occurs commonly in elderly age group and females, typically occurs due to low-energy trivial falls and may be associated with osteoporosis.1,2,3,4 The prevalence of fracture neck of femur doubles after the fifth decade of life. The incidence of fracture neck of femur has increased in recent decades.5,6 This fracture remains even today a challenge, as far as treatment and results are concerned. There are certain anatomical features peculiar to this fracture, which need consideration. Femoral neck fractures usually are entirely intracapsular, and common to all intracapsular fractures, the synovial fluid bathing the fracture may interfere with the healing process, because the femoral neck has essentially no periosteal layer, all healing must be endosteal. Angiogenic inhibitory factors in synovial fluid also can inhibit fracture repair. These factors, along with the precarious blood supply to the femoral head, make healing unpredictable and results in frequent non-unions. Because of the anatomical configuration of the bone and action of various groups of muscles, this fracture is subjected to a very high degree of shearing strain. Because of these factors, a displaced fracture neck of femur doesn’t unite, unless it is reduced and internally fixed. Even undisplaced fractures can get displaced and go in to non-union. This study is done to evaluate the demographic details, types of fractures and injuries leading to fracture neck of femur. MATERIALS AND METHODS Twenty-five patients admitted in department of orthopaedics and traumatology of Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation were screened and enrolled for this study. This study was conducted from May 2010 to October 2012. Detailed history and clinical examination were conducted. Patients satisfying inclusion and exclusion criteria were enrolled. Fracture neck of femur was confirmed by radiological evaluation. All the data was presented in numbers and percentages. RESULTS In our study, 52% were between 40-60 yrs. age group and 48% were from 60-70 yrs. Age group. Females were 56% and 44% were males in this study. Left side fracture neck of femur (60%) was more common than the right side (40%). Fracture neck of femur due to a trivial fall was observed in 40% of cases and 60% was due to road traffic accident. Fracture neck of femur type II occurred in 4%, type III in 44% and type IV in 48% of patients. CONCLUSION This study concludes that fracture neck of femur is commonly observed in elderly patients and females were affected more than the males due to low bone density. Left side fracture neck of femur was more common. Type III and type IV fracture neck of femur contributed in majority of patients.