- Majority of the blood supply is from metaphysis to epiphysis, hence fracture neck femur has higher incidence of AVN.
- Since the neck is intracapsular – the synovial fluid and lack of periosteum interferes with fracture healing
- Anatomical, Pauwels, Gardens and AO classification are commonly used to classify neck fractures
- Treatment depends on age, duration and type of fracture
- Whitman and lead better techniques are used for closed reduction and gardens alignment index to assess the reduction followed by CC screw fixation.
- Loss of vascularity, malreduction, poor bone quality, posterior comminution, capsular tamponade can all lead to non union
- Pauwel’s valgus osteotomy is most commonly used to treat non-union with viable head in young patients, other techniques include Meyers muscle pedicle graft, McMurrys osteotomy.
