*Institute for Biomechanics, BG Unfallklinik Murnau, Murnau, Germany; and †Institute for Biomechanics, Paracelsus Medical University Salzburg, Salzburg, Austria.
J Orthop Trauma. 2019 Jan;33 Suppl 1:S27-S32. doi: 10.1097/BOT.0000000000001365.
Fractures of the femoral neck can occur in young healthy individuals due to high loads occurring during motor vehicle accidents, impacts, or falls. Failure forces are lower if impacts occur sideways onto the greater trochanter as compared with vertical loading of the hip. Bone density, bone geometry, and thickness of cortical bone at the femoral neck contribute to its mechanical strength. Femoral neck fractures in young adults require accurate reduction and stable internal fixation. The available techniques for fracture fixation at the femoral neck (cannulated screws, hip screw systems, proximal femur plates, and cephallomedullary nails) are reviewed with respect to their competence to provide biomechanical stability. Mechanically unstable fractures require a load-bearing implant, such as hip screws, with antirotational screws or intramedullary nails. Subcapital or transcervical fracture patterns and noncomminuted fractures enable load sharing and can be securely fixed with cannulated screws or solitary hip screw systems without compromising fixation stability.
股骨颈骨折可发生于年轻健康个体，原因是交通意外、撞击或摔倒时会产生高负荷。与髋关节垂直受力相比，侧向撞击大转子会导致更低的失效力。股骨颈的骨密度、骨几何形状和皮质骨厚度有助于其机械强度。年轻成人的股骨颈骨折需要准确复位和稳定的内固定。对股骨颈骨折固定的现有技术（空心螺钉、髋螺钉系统、股骨近端板和股骨近端髓内钉）进行了综述，讨论了它们提供生物力学稳定性的能力。机械不稳定的骨折需要使用带抗旋螺钉或髓内钉的负重植入物，如髋螺钉。头下型或经颈型骨折模式和非粉碎性骨折能够分担负荷，并且可以使用空心螺钉或单独的髋螺钉系统安全固定，而不会影响固定稳定性。
