Wasmuth H H, Henriksen J, Knobloch R
Kirurgisk avdeling, Harstad sykehus.
Tidsskr Nor Laegeforen. 1991 Sep 30;111(23):2837-9.
Postoperative secondary displacement of displaced femoral neck fractures is a major problem in the treatment of this fracture. In a study of 232 femoral neck fractures operated at the Department of Surgery, Harstad Hospital and at the Departments of Surgery and Orthopaedics, Tromsø University Hospital, the reduction was lost in 12% of the displaced fractures within three months. The fractures were fixated with two 6 mm screws (Olmed). The deep infection rate was 3.4%. There were significant differences between the hospitals. The rate of redisplacement was 5% at Harstad Hospital and 29% at the Tromsø University Hospital (p less than 0.001), the rate of deep infection was 1.8% versus 7.5% (p less than 0.05). Early complications are caused by poor quality of reduction and incorrect positioning of the screws. The surgeons' lack of experience in treating these fractures gives rise to a high rate of complications. The main reason for the low rate of complications in the material from Harstad Hospital is continuous and prospective quality control of femoral neck fractures. Such continuous feedback, and an interest intreating these fractures among the surgical staff, obviously improves the results. When the Olmed method of fixation is used correctly the rate of early complications is small.
