ArticleOperative Orthopadie und Traumatologie2026
Closed reduction of acute femoral neck fractures-a simple and reproducible technique.
Article in Operative Orthopadie und Traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveSurgical technique of closed reduction followed by percutaneous fixation of acute femoral neck fractures. INDICATIONS: Displaced femoral neck fractures. CONTRAINDICATIONS: Open femoral neck fractures and concomitant neurovascular injuries. SURGICAL TECHNIQUE: The patient is positioned supine on a traction table, ensuring optimal fluoroscopic visualization. Closed reduction is attempted before draping to assess reducibility. Gentle axial traction restores length and valgus alignment, followed by internal rotation to correct anterior angulation and restore alignment, guided by the disappearance of the lesser trochanter. Minor adjustments in abduction or adduction optimize reduction, and traction is released to maintain cortical contact. Final reduction is verified fluoroscopically in two planes according to the surgeon's assessment the Garden classification, and Lowell's criteria.
resultsBetween 2012 and 2021, the data of 55 patients under 65 years of age with a femoral neck fracture were collected for a retrospective cohort study. Of these 55 patients, 51 were treated with closed reduction followed by percutaneous fixation. The median (interquartile range [IQR]) age was 58 years (48-60), and the operation was accomplished in 54 min (38-90). During the median (IQR) follow-up time of 12 months (6-14), a total of 10 complications were reported. Eight patients required conversion to a total prosthesis; five due to avascular necrosis, three due to nonunion. One patient needed reoperation because of an inappropriately long 7.5-mm cannulated screw, and one patient required antibiotic therapy due to a superficial wound infection. The quality of reduction was radiographically intra- and/or postoperatively rated by three experienced trauma surgeons based on the overall impression. The statistical analyses revealed a satisfactory reduction result in approximately 90% of the cases.
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