Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jul 31;57(8):791.
doi: 10.3390/medicina57080791.

Intracapsular Femoral Neck Fractures-A Surgical Management Algorithm

James W A Fletcher  1   2 , Christoph Sommer  3 , Henrik Eckardt  4 , Matthias Knobe  5 , Boyko Gueorguiev  1 , Karl Stoffel  4
Affiliations
Review

Intracapsular Femoral Neck Fractures-A Surgical Management Algorithm

James W A Fletcher et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Femoral neck fractures are common and constitute one of the largest healthcare burdens of the modern age. Fractures within the joint capsule (intracapsular) provide a specific surgical challenge due to the difficulty in predicting rates of bony union and whether the blood supply to the femoral head has been disrupted in a way that would lead to avascular necrosis. Most femoral neck fractures are treated surgically, aiming to maintain mobility, whilst reducing pain and complications associated with prolonged bedrest. Materials and Methods: We performed a narrative review of intracapsular hip fracture management, highlighting the latest advancements in fixation techniques, generating an evidence-based algorithm for their management. Results: Multiple different fracture configurations are encountered within the category of intracapsular hip fractures, with each pattern having different optimal surgical strategies. Additionally, these injuries typically occur in patients where further procedures due to operative complications are associated with a considerable increase in mortality, highlighting the need for choosing the correct index operation. Conclusions: Factors such as pathological causes for the fracture, pre-existing symptomatic osteoarthritis, patient's physiological age and fracture displacement all need to be considered when choosing optimal management.

Keywords: algorithm; arthroplasty; femoral neck fractures; fixation; hip fractures; screws; surgical management.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Surgical algorithm for intracapsular femoral neck fractures.
See this image and copyright information in PMC

References

    1. Kanis J.A., Johnell O., Oden A., Sernbo I., Redlund-Johnell I., Dawson A., De Laet C., Jonsson B. Long-Term Risk of Osteoporotic Fracture in Malmö. Osteoporos. Internat. 2000;11:669–674. doi: 10.1007/s001980070064. - DOI - PubMed
    1. Burge R., Dawson-Hughes B., Solomon D.H., Wong J.B., King A., Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res. 2007;22:465–475. doi: 10.1359/jbmr.061113. - DOI - PubMed
    1. Thakar C., Alsousou J., Hamilton T.W., Willett K. The cost and consequences of proximal femoral fractures which require further surgery following initial fixation. J. Bone Jt. Surg. Br. 2010;92:1669–1677. doi: 10.1302/0301-620X.92B12.25021. - DOI - PubMed
    1. Royal College of Physicians . National Hip Fracture Database Annual Report. Royal College of Physicians; London, UK: 2019.
    1. Augat P., Burger J., Schorlemmer S., Henke T., Peraus M., Claes L. Shear movement at the fracture site delays healing in a diaphyseal fracture model. J. Orthop. Res. 2003;21:1011–1017. doi: 10.1016/S0736-0266(03)00098-6. - DOI - PubMed