[Covered osteosynthesis through cannulated screws in medial Garden type I and II femoral neck fractures].

Fracture of the femoral neck is a common problem in elderly patients. In these patients with concomitant illness and medical complications the hip fracture is then often the reason for a long-term institutionalization with serious implications for the outcome. While the treatment of displaced femoral neck fractures Garden's stage III and IV is quite clear, the procedure for impacted or undisplaced fractures Garden's stage I or II is still the subject of controversy. In a retrospective study was shown that conservative treatment of impacted or undisplaced femoral neck fractures is associated with a high complication rate of 30-40%. When these femoral neck fractures were broken down according to Garden's classification the complication rate in cases of Garden's stage II was found to be 1.5 times that in femoral neck fractures in Garden's stage I. With a P-value less than 0.05 this difference was statistically significant (Wilcoxon test). Because of these major problems associated with conservative treatment we changed our current algorithm. Covered internal fixation with cancellous screws is now considered to be indicated for all impacted or undisplaced femoral neck fractures. Between 1990 und 1992, 53 patients (42 female, 11 male) with femoral neck fracture in Garden's stage I (24 patients) or II (29 patients) were treated in our Department of Traumatology with 6.5 mm cancellous screws. In all case early mobilization and weight-bearing were allowed. In this prospective study the average follow-up was 14.3 +/- 2.1 months (range 8-20 months).(ABSTRACT TRUNCATED AT 250 WORDS)