Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA …

Femoral Neck Anatomy

• Normal neck–shaft angle ? 130°.
• Femoral neck anteversion ? 10°.

Calcar Femorale

• Calcar is a dense posteromedial plate of bone.
• It acts as a stress?transfer structure.
• Forms an internal strut in the inferior femoral neck and intertrochanteric region.

Biology of Femoral Neck Fractures

• No periosteum around the femoral neck.
• Lack of abundant callus formation.
• Fracture healing occurs mainly through internal (endosteal) proliferation.

Blood Supply

• The most important blood supply to the femoral head is the medial femoral circumflex artery.
• Injury to retinacular vessels increases risk of avascular necrosis.

Mechanism of Injury

• In young patients femoral neck fractures usually occur due to high?energy trauma.

Complications

• Avascular necrosis of femoral head.
• Non?union of the fracture.
• Risk increases with greater displacement of the fracture.
• More vertical fracture patterns also increase complication risk.

Principles of Management

• Urgent surgery is recommended in young patients to decompress compressed vessels.
• Goal of treatment is anatomic reduction.
• Reduction can be performed using closed methods.

If closed reduction fails, open reduction should be performed