Extra-articular internal fixation of femoral-neck fractures by means of the devices and method which we have described is so easily accomplished and has been productive of such good results that we believe it is the procedure of choice, regardless of the age and general condition, for any patient who is not already dying. Consequently, we think it unnecessary to submit such patients to the increased hazard of arthrotomy.
Fixation has facilitated general care, promoted comfort, lessened the incidence of complications, and bettered the chance of weathering such complications when they have occurred. It affords the best possibility of ultimate recovery. In the case of those patients for whose recovery there is no reasonable hope, we believe that the greater temporary comfort afforded by fixation makes this active intervention more humanitarian than any less positive plan of treatment.
With resolution born of these convictions, we use the lock-bolt method of fixation in any fracture of the femoral neck, if the patient is not already moribund. While we have had no poor results in patients who were favorable risks, we have been gratified to have obtained good results in some extremely unpromising cases.
From the point of view of recovery or of the accumulation of favorable statistics, the patients who died were obviously impossible surgical risks. In these cases the lock-bolt method was used to promote temporary comfort, to facilitate nursing care, and to render the patients' last days more tolerable. These facts should be kept in mind in making comparisons with other series of cases.
(C) 1940 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.