Treatment of femoral neck fractures at the turn of the century

On the basis of world literature data review and personal observations the authors conclude that primary osteosynthesis should be performed on the day of patient’s admission in case no special contraindications are present. The application of massive monolithic fixators is not expedient because of their depress the reparative regeneration in fracture zone and damage blood supply of the femoral head. Two fixators are sufficient for stable osteosynthesis: distal fixator is placed with support at Adams arch and/or Markel «spur» and prevents varus deformity of the femoral head and neck; proximal fixator is inserted into cortex of the femoral neck and prevents the backwards displacement. Stabilisation of femoral neck fragments with screws should be performed by their maximum insertion into cortical bone. Unipolar prosthesis of the femoral head or total hip replacement are indicated mainly in failed osteosynthesis.