- 作者：Kin Weng Wong ; Wei-Ting Lin ; kinwengw@yahoo.com ; Chi-Sheng Chien ; Chung-Da Wu
- 关键词：end-stage renal disease ; femoral neck fractures ; osteosynthesis
- 刊名：Formosan Journal of Musculoskeletal Disorders
- 出版年：2012
- 期刊代码：pca163_22107940
- 类别：med
- 出版时间：May, 2012
- 卷：3
- 期：2
- 页码：56-60
- 文件大小：361 K
Background
Treatment of femoral neck fracture is well documented in the literature. Femoral neck fractures in patients aged < 65 years are generally treated using closed reduction and internal fixation, while hemiarthroplasty is the treatment of choice for patients > 65 years. In specific populations, such as patients with end-stage renal disease (ESRD), this protocol is usually observed. However, unsatisfactory results and a large number of complications have been reported. It is questionable whether this protocol is the appropriate treatment and it may require modification for use in ESRD patients.Materials and methods
The results of this study are in regard to the treatment of a consecutive series of 20 patients with femoral neck fractures and ESRD over a 7-year period. All of the patients were treated using closed reduction and internal fixation.
Results
Eight of 13 (61.5%) patients developed nonunion (of which 5 were classified as displaced fractures). Six of these eight patients were subsequently treated with hemiarthroplasty (75%). Five of these 13 patients(38.4%) achieved union; all of these were classified as nondisplaced fractures. In patients < 70 years, five of 11 patients demonstrated nonunion (45.5%), of which all were classified as displaced fractures. The mortality rate of this series was 33.3%(5 of 15 patients).
Conclusion
We determined that a femoral neck fracture in an ESRD patient is a unique case and should be treated differently from general treatment protocols. It is suggested that regardless of patient age,nondisplaced fractures should be treated with osteosynthesis, while hemiarthroplasty is a better treatment for displaced fractures.