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On the basis of the case histories of 45 subcapital fractures of the femoral neck treated by hip arthroplasty (endoprothesis) indication and long-term results are demonstrated (average period after operation 54 months, longest period 16 years). Late complications (acetabular erosion, loosening) and possibilities to prevent them are discussed.
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OBJECTIVE: In peri- and postmenopausal women, the association of skin thickness with bone mass is well described, and a low skin thickness is a useful predictor of osteoporosis. In this study the association between skin thickness and bone mass of femoral neck in peri- and postmenopausal women was assessed; and the potential for skin thickness as a screening test for osteoporosis evaluated. DESIGN/METHODS: Skin thickness was measured at the arm by ultrasonography (probe 22 MHz). Bone mass was measured at the neck of femur by dual-energy X-ray absorptiometry. One hundred and three peri- and postmenopausal women were studied. RESULT: Successive decrease of skin thickness going along with the loss of femoral neck bone mass was found. There was a statistically significant difference in skin thickness between group of females with normal bone mass and group with osteopenia (p < 0.05) and osteoporosis (p < 0.01). CONCLUSIONS: Ultrasound skin measurement is a very simple method which can be used in the diagnostics of osteopenia and osteoporosis of the neck of femur in peri- and postmenopausal women.
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The medial fracture of the femur neck is mainly a fracture of the old man. It is well known, that often only minimal traumas are caused for the medial fracture of the femur neck. Osteoporosis alone is not the reason for fracture. A deficiency in trace elements especially for the old patients is often discussed, but there are no exact examinations yet. For this analysis the concentration magnesium, copper and zinc was performed from 10 patients which got a medial fracture of the femur neck. Bone-biopsy and blood was taken when an endoprothesis was implanted. We could find a decreased zinc concentration in all bones. The copper and magnesium concentration in bone was not significant depressed. Both elements have a great individual spread. There are no significant alterations in blood levels of magnesium, copper and zinc in patients with a medial fracture to normal population.
We carried out researches with the purpose of comparison of operative treatment results of femur neck fractures in elderly and senile patients with those in other countries. Total hip replacement technique was used over the period of 1991-2002 yy. for 123 patients with femur neck fractures. We have used "Smith & Nephews" or "Zimmer" prostheses with "Polacos" or "Osteobond" acrylcements. Surgical approach tactics is very important for prophylaxis of early and late postoperative complications. Active and of sound mind patients with femur neck fractures should undergo total hip replacement procedure. Rehabilitation is also an important factor in preventive early and late postoperative complications.
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Between 1969 and 1978 in 42 patients fractures of the femur-neck were treated with three AO-screws for spongiosa (screws with a short thread). Late results in these patients are reported. The interval between operation and follow-up was in average 90 months. In no case pseudarthrosis had developed; the rate of necrosis of the femur head was 23.8%. The method is suitable in selected cases of medial fractures of the femur-neck, type I and II, and in lateral fractures, preferably in younger patients. The results in fractures of type III according to Pauwels show, that in advanced age these fractures should be treated with a partial or total prosthesis, because the rate of necrosis of the femur-head cannot be lowered.
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