Kofoed H
Injury. 1982 Sep;14(2):146-50. doi: 10.1016/0020-1383(82)90049-3.
Seventeen young adults with subcapital femoral neck fractures that occurred after injury and with no signs of osteoporosis were treated conservatively (2 cases) or by closed reduction and internal fixation. Evaluation of the results was based on clinical, radiological and scintigraphical examinations. The incidence of non-union was 24 per cent (4/17) and the incidence of avascular necrosis of the femoral head was 41 per cent (7/17). The total failure rate was 41 per cent as all fractures with non-union also had avascular necrosis. It was found that reduction was the most important factor determining the outcome, as only 17 per cent (2/12) of fractures with a good reduction subsequently developed non-union compared with 100 per cent (5/5) with malreduction. High-velocity injury was no more crucial than low-velocity injury. The final outcome of femoral neck fractures in young persons did not differ from the known outcome in elderly persons.
17名股骨颈头下型骨折的年轻成人,骨折由外伤引起且无骨质疏松迹象,接受了保守治疗(2例)或闭合复位内固定治疗。结果评估基于临床、放射学和骨闪烁显像检查。骨不连发生率为24%(4/17),股骨头缺血性坏死发生率为41%(7/17)。由于所有发生骨不连的骨折均伴有缺血性坏死,总失败率为41%。研究发现,复位是决定预后的最重要因素,因为复位良好的骨折随后发生骨不连的比例仅为17%(2/12),而复位不良的骨折这一比例为100%(5/5)。高速损伤并不比低速损伤更关键。年轻人股骨颈骨折的最终预后与老年人已知的预后并无差异。