Executive Editor: Joseph Schatzker, Peter Trafton

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

Proximal femur - Femoral neck fracture, subcapital, undisplaced or impacted

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Preliminary remark

Impacted fractures are relatively stable. Thus, in some parts of the world they are treated nonoperatively. The patient is allowed limited weight bearing and the position of the fragments is checked radiologically.

About 10-50% of these fractures will displace. The majority of surgeons consider this risk unacceptable and prefer therefore to fix these fractures with cannulated screws which prevents this complication.


Treatment guidelines

Mobilization starts as soon as pain is tolerable. Partial weight bearing if possible, full weight bearing if necessary.

8 weeks after injury, full weight bearing can be started.

Functional treatment is continued until fracture healing.

In case of secondary displacement, treat the fracture like a primarily displaced fracture.

X-ray control should be performed only if pain does not subside, or returns.

v2.0 2010-11-14