• Patrick K Cronin, David M Freccero, Michael S Kain, Andrew J Marcantonio, Daniel S Horwitz, and Paul Tornetta.
• Department of Orthopaedic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA.
• J Orthop Trauma. 2019 Mar 1; 33 (3): 116-119.

ObjectivesTo report on the final displacement after in situ percutaneous pinning for Garden type 1 and 2 fractures in height, femoral neck fracture collapse, and loss of offset.DesignRetrospectively reviewed case series.SettingThree Academic Medical Centers. Boston University Medical Center (Level 1 Trauma Center), Lahey Hospital and Medical Center (Level 2 Trauma Center), and Geisinger Medical Center (level 2 Trauma Center).Patients/ParticipantsOne hundred thirty skeletally mature patients with 130 fractures (78 garden 1 and 52 garden 2) who were treated between January 2000 and January 2014 at participating hospitals with percutaneous pinning with a cannulated screw system to successful union after sustaining an intracapsular femoral neck fracture without complete displacement.InterventionIn situ percutaneous pinning with 3 cannulated, partially threaded screws in an inverted triangle orientation.Main Outcome MeasurementsFemoral neck fracture collapse (mm), femoral height shortening (mm), and femoral offset shortening (mm).ResultsA total of 130 patients (81F, 49M), average age 72 years, sustained 78 Garden 1 and 52 Garden 2 femoral neck fractures. Maximal collapse occurred in the plane of the femoral neck. Thirty-three of 78 (42%) Garden 1 fractures and 33/52 (63%) Garden 2 fractures demonstrated >10 mm fracture collapse. The range of displacements was 0-39 mm as measured along the plane of the femoral neck.ConclusionsGarden 1 fractures collapse less frequently than Garden 2 fractures, but both have high rates of fracture collapse when treated to union with in situ percutaneous pin fixation.Level Of EvidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

24 keywords...

hide…