Femoral Neck Fractures - Semantic Scholar

Femoral Neck Fractures

Carol Lin, MD & Brad Merk, MD

Original Authors: Brian Boyer, MD; March 2004 Steven A. Olson, MD; March 2006 James C. Krieg, MD; May 2011

Revised: March 2016

Epidemiology

? > 300,000 Hip fractures annually in the US

? Accounts for 30% of all hospitalizations ? Expected to surpass 6 million annually

worldwide by 2050

? Significant morbidity, mortality, expense

? $10-15 billion/year in the US

data/hcup; Kannus et al, Bone 1996; Dy et al, JBJS 2011

Epidemiology: Bimodal Distribution

? Elderly

? incidence doubles each decade beyond age 50

? higher in caucasians ? smokers, lower BMI, excessive caffeine & ETOH

? Young

? high energy trauma

Anatomy

? Physeal closure age 16 ? Neck-shaft angle

130? ? 7? ? Anteversion

10? ? 7? ? Calcar Femorale

Posteromedial dense plate of bone

calcar

Images from: Court-Brown, C. et al. Rockwood & Greens Fractures in Adults. Philadelphia: Lippincott Williams & Wilkins, 2014

Blood Supply

? Lateral epiphysel artery

? terminal branch MFC artery ? predominant blood supply to

weight bearing dome of head

? After fracture, blood supply depends on retinacular vessels

Images from: Court-Brown, C. et al. Rockwood & Greens Fractures in Adults. Philadelphia: Lippincott Williams & Wilkins, 2014

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