In young patients, the femoral head should be preserved and fixed internally. In elderly patients with osteoporosis and/or preexisting hip arthritis, arthroplasty is more commonly chosen.
These fractures are more vertical and often can not provide a fulcrum for stable screw fixation, so there would be a high risk of secondary displacement.
Reduction should begin closed and may be extended with percutaneous fragment manipulation. If this still does not provide satisfactory reduction, open reduction is mandatory.
In elderly patients, these fractures have a high risk of failed fixation, nonunion, and avascular necrosis. For appropriately selected patients, arthroplasty may be more successful. This would reduce the need for reoperation and allows early weight bearing. It is, however, a bigger operation with possible serious complications.
Elderly patients will not mobilize easily with restricted weight bearing. Therefore, procedures allowing for immediate weight bearing as tolerated with walking aids should be selected whenever possible.
In young patients, the femoral head should be preserved and fixed internally. In elderly patients with osteoporosis and/or preexisting hip arthritis, arthroplasty is more commonly chosen.
These fractures are more vertical and often can not provide a fulcrum for stable screw fixation, so there would be a high risk of secondary displacement.
Reduction should begin closed and may be extended with percutaneous fragment manipulation. If this still does not provide satisfactory reduction, open reduction is mandatory.
In elderly patients, these fractures have a high risk of failed fixation, nonunion, and avascular necrosis. For appropriately selected patients, arthroplasty may be more successful. This would reduce the need for reoperation and allows early weight bearing. It is, however, a bigger operation with possible serious complications.
Elderly patients will not mobilize easily with restricted weight bearing. Therefore, procedures allowing for immediate weight bearing as tolerated with walking aids should be selected whenever possible.
Implants not available, missing infrastructure for surgical intervention, first aid
Disadvantages
Implants not available, missing infrastructure for surgical intervention, first aid
Disadvantages
Patient not fit for surgery
Disadvantages
Patient not fit for surgery
Disadvantages
Pauwels type II + III fracture, good bone quality
Further indication
Contraindication
Advantages
Disadvantages
Pauwels type II + III fracture, good bone quality
Further indication
Contraindication
Advantages
Disadvantages
Pauwels type II + III fracture, good bone quality
Further indication
Contraindication
Advantages
Disadvantage
Pauwels type II + III fracture, good bone quality
Further indication
Contraindication
Advantages
Disadvantage
Elderly patient with osteoporosis
Contraindication
Advantages
Disadvantages
Elderly patient with osteoporosis
Contraindication
Advantages
Disadvantages
Elderly healthy and active patient with osteoporosis
Further indication
Contraindications
Advantages
Disadvantages
Elderly healthy and active patient with osteoporosis
Further indication
Contraindications
Advantages
Disadvantages
