
Giacomo Trivellin
Pederzoli Hospital, ItalyTitle: Femoral reduction and fixation of femural neck fracture in young people by direct anterior approach : A case report
Abstract
Femoral neck fractures in young adults are uncommon and
often the result of high-energy trauma. They are associated with higher
incidences of femoral head osteonecrosis and non-union. Multiple factors can
play a significant role in preventing these devastating complications and
contribute to a good outcome. While achieving an anatomic reduction and stable
internal fixation are imperative, other treatment variables, such as time to
surgery, the role of capsulotomy and the fixation methods remain debatable.
Watson-Jones exposure is the recommended approach. Definitive fixation can be
accomplished with three cannulated or no cannulated cancellous screws. But we
want to demonstrate that direct anterior approach is a valid alternative to
respect anatomy with a significative case report. An 18 years old boy, was
taken in emergency room in an afternoon of February 2021. After a motorbike
accident ha reporter, a femoral neck fracture, classifiable as 4° degree of
Garden Classification. To respect his soft tissue, the fracture was immediately
reduced in operative room by anterior direct approach and then fixated with two
cannulated screws. Partial weight bearing was conceded a few days after the
operation. The clinical and radiological follow was performance every two
months. After one year we can see a perfect healing and no signs of necrosis or
arthritis. He returned after two months at every day’s activities and after six
months to sport activities. We think than direct anterior approach is
preferable in young people to fully respect the anatomy. The most important
thing is timing, immediate intervention is necessary to avoid the classical
complications.
Biography
Giacomo Trivellin was born in Vicenza, Italy in the 1984. He
was graduated in Medicine and Surgery at Trieste University and specialized in
Orthopedics and Traumatology at Verona University in 2010. His activity is
based most on trauma and hip surgery. He is author of several publication on
international papers and participate like relator in several international
congress.