Indications

• Non-displaced fractures of neck of femur (Garden grade I, II).

• Displaced fractures of the femoral neck in a physiologically/biologically young patient after adequate reduction has been obtained.

Preoperative planning

Clinical assessment

• Groin pain localized in the affected hip side – radiation of pain to the knee.

• The limb is shortened and externally rotated.

• Assess and document the neurovascular status of the leg.

• In young patients careful examination for other injuries must be made, as femoral neck fractures are the result of high-energy trauma.

• Perform a complete medical examination in elderly patients.

Radiological assessment

• Anteroposterior and lateral radiographic views of the afected hip (Fig. 10.3.1).

• Anteroposterior radiograph of the pelvis.

• Evaluate head retroversion and posterior comminution.

• Assess the primary, secondary compression lines and the tension trabeculae on radiographs (Singh).

• Assess the ‘verticality’ of the fracture using the Pauwels classiication.

• An MRI or a CT is indicated when physical history and/or signs are suggestive of a fracture and this is not clear on the plain radiographs.