SURGICAL MANAGEMENT OF INTRACAPSULAR NECK OF FEMUR FRACTURES IN YOUNG PATIENTS.IS THERE A SUPERIOR INTERNAL FIXATION DEVICE FOR THEIR MANAGEMENT?

Introduction: Intracapsular neck of femur fractures in young patients (age<60) are usually high energy injuries, associated with high complication rates (malunion, nonunion, avascular necrosis, shortening of vertical and longitudinal femoral offsets).

Aim: This study aims to present the key points of the surgical management of the intracapsular neck of femur fractures in young patients.

Material & Methods: Retrospective review of the literature and outcomes of different internal fixation methods (dynamic/sliding hip screw, cannulated compression screws, femoral neck system).

Results: Anatomical reduction and stable internal fixation of the intracapsular neck of femur fractures is imperative. This can be achieved with closed +/- open reduction. Different surgical approaches have been described for maximum visualisation of the femoral neck and adequate access for open reduction.

Conclusions: Multiple cannulated compression screws are used traditionally between most surgeons for the management of intracapsular neck of femur fractures. Femoral Neck System (FNS) has increasing popularity and evidence showing satisfactory clinical outcomes and clinical efficacy.  Nevertheless, multicentre RCTs are needed to draw safe conclusions regarding the optimal internal fixation device for the management of the intracapsular neck of femur fractures in young patients.