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Femoral Neck Fractures in the Physiologically Young Patient

Carroll, Eben A., MD

Journal of Orthopaedic Trauma: January 2019 - Volume 33 - Issue - p S1
doi: 10.1097/BOT.0000000000001364
Introduction

Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.

Reprints: Eben A. Carroll, MD, Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 (e-mail: ecarroll@wakehealth.edu).

The author reports no conflict of interest.

Accepted October 10, 2018

Femoral neck fractures in young patients remain extremely challenging to manage because of a tenuous blood supply and a disadvantageous fracture healing environment. This has resulted in high rates of nonunion and avascular necrosis. Little Level I data exist to guide the treating surgeon with regard to timing of fixation, type of reduction (open vs. closed), or the optimal implant to stabilize these fractures.

This supplement will review the current state of the art with regard to the management of these injuries. It will review the biomechanics and current challenges. The supplement will focus on ways to maximize success from a reductive and implant standpoint. Particular attention will be paid to the advantages and disadvantages of the commonly used montage of implants. We will introduce a newer generation of femoral neck implants. These new hybrid fixed-angle constructs build on the strengths and diminish the shortcomings of traditional treatment options and may decrease rates of nonunion and avascular necrosis. With this supplement, we hope to add to the dialog and discussions on how to improve outcomes for patients sustaining these life-changing injuries and to inspire Level I studies to be conducted in the future.

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