Executive Editor: Joseph Schatzker, Peter Trafton

Authors: Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken

Proximal femur - Femoral neck fracture, subcapital, displaced

General considerations

Neck fractures are extraarticular but intracapsular; the articular surface is not damaged.

In displaced subcapital fractures the fracture line follows the border of the articular cartilage and the blood supply to the femoral head is disrupted in most cases.

There is still some debate about the relative merits of fixation vs. arthroplasty, and the best indications for each, but arthroplasty is more commonly chosen in these fractures.

A sliding hip screw should be preferred over multiple smaller screws, if intrinsic stability is questionable, particularly in osteoporotic bone, or in case of a comminuted fracture.

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v2.0 2010-11-14