Azar Masoud Shayesteh, Saravi Majid Sajjadi, Kariminasab Mohammad Hossein, Taghipour Mehrdad, Sharifian Rayka
Department of Orthopedic Surgery, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Am J Case Rep. 2012;13:22-5. doi: 10.12659/AJCR.882472. Epub 2012 Feb 8.
Fracture of the femoral neck is still a medical dilemma due to high rates of complications and the choice of treatment. Although rigid internal fixation with cannulated screws through open or percutaneous approaches is the traditional treatment for undisplaced fractures (Garden type I and II) to avoid secondary displacement, considerable controversy still exists regarding the rate of this problem, thus it seems that a new trend in conservative management of this types of femoral neck fracture is emerging.
Our case is a 46-year-old woman with Garden type II femoral neck fracture, who refused all surgical options and willingly ignored her problem. Six months later she returned to our center with uneventful recovery of her fracture.
The previous belief about the absolute poor prognosis of Garden type II with 100% rate of secondary displacement with non-operative management must have been an overestimation or the success histories in the literature about non-operative treatment of these fractures originates from inherited weakness of the Garden classification in differentiating type I from type II. The patient gave the informed consent prior being included into the study.
由于并发症发生率高以及治疗选择，股骨颈骨折仍然是一个医学难题。尽管通过开放或经皮入路使用空心螺钉进行坚强内固定是无移位骨折（Garden I型和II型）的传统治疗方法，以避免继发移位，但关于这一问题的发生率仍存在相当大的争议，因此，对于这类股骨颈骨折的保守治疗似乎正在出现一种新趋势。
我们的病例是一名46岁女性，患有Garden II型股骨颈骨折，她拒绝了所有手术选择，并故意忽视自己的问题。六个月后，她回到我们的中心，骨折顺利愈合。
以往认为Garden II型骨折非手术治疗继发移位率达100%，预后绝对不良的观点肯定是高估了，或者文献中这些骨折非手术治疗的成功案例源于Garden分型在区分I型和II型时存在固有缺陷。该患者在被纳入研究前已签署知情同意书。
