Complete spontaneous improvement of non-displaced femoral neck fracture without any surgery modality

Abstract

Background: 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.

Case report: 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.

Conclusions: 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.

Keywords: femoral neck fracture; non-displaced fracture; non-operative treatment.

Figure 1

Simple X-Ray of the left hip showed non-displaced femoral neck fracture 20 days after trauma (May 2010).

Figure 2

Simple X-Ray of the left hip, 6 months after trauma (November 2010).