مرکز منطقه ای اطلاع رساني علوم و فناوري - Fixation of intracapsular femoral neck fractures: Effect of trans-osseous capsular decompression

Abstract :

Objectives: Intracapsular femoral neck fractures have been found as associated with hemarthrosis. The fluid in the intact capsule elevates the intracapsular pressure to a level could tamponades the vascular supply of the femoral head. Therefore, capsular decompression seems necessary to salvage the femoral head circulation. Negative impact of the capsular incision also has been reported. Therefore, we hypothesize that creation of a trans-osseous portal can decompress the capsule as well as not threaten the capsular related blood vessels. Materials and methods: In present study, 27 patients with intracapsular femoral neck fractures were included. Coinciding with closed reduction and internal fixation we made a trans-osseous portal for capsular decompression. Patients were followed-up prospectively for a mean period of 43.1 months. Results: All fractures united. However, one patient 17 years-old who was nursed preoperatively in skin traction developed osteonecrosis of the femoral head. Conclusion: Our results supported that the trans-osseous capsular decompression has evacuated the intracapsular haematoma and has not threatened the capsular integrity. Preoperative traction of the injured limb particularly in the young patient may play a role in development of osteonecrosis of the femoral head.