As part of a periodic, continuing study of displaced intracapsular fractures of the femoral neck at one hospital, begun in 1930, 187 fractures were reviewed bringing the total to 800 and the number of fractures treated by the Pugh nail to 321, of which 256 had been followed for an average of thirty-two months. Of the 256, twenty-six failed to unite and 230 (90 per cent) united, but in forty (17 per cent) of the cases of union avascular necrosis developed, causing few if any symptoms in twenty-four and severe symptoms associated with collapse of the head in sixteen. The results were, therefore, satisfactory in 214 (84 per cent) of the 256 patients. The results in the two series of fractures treated with Pugh nails and analyzed between 1952 and 1971 were essentially the same (90 per cent union in both and avascular necrosis in 18.5 and 15 per cent, respectively, of the united fractures). These results were also the best that had been achieved in the forty-one years covered by the study, and it was concluded that they are probably the best that can be achieved at this institution.
From the Orthopaedic Service of St. Luke's Hospital, New York City