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      Complete spontaneous improvement of non-displaced femoral neck fracture without any surgery modality

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          Background:

          Fracture of the femoral neck is still a medical dilemma due to high rates of complications and the choice of treatment. Although rigid internal fixation with cannulated screws through open or percutaneous approaches is the traditional treatment for undisplaced fractures (Garden type I and II) to avoid secondary displacement, considerable controversy still exists regarding the rate of this problem, thus it seems that a new trend in conservative management of this types of femoral neck fracture is emerging.

          Case Report:

          Our case is a 46-year-old woman with Garden type II femoral neck fracture, who refused all surgical options and willingly ignored her problem. Six months later she returned to our center with uneventful recovery of her fracture.

          Conclusions:

          The previous belief about the absolute poor prognosis of Garden type II with 100% rate of secondary displacement with non-operative management must have been an overestimation or the success histories in the literature about non-operative treatment of these fractures originates from inherited weakness of the Garden classification in differentiating type I from type II. The patient gave the informed consent prior being included into the study.

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          Most cited references33

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          Hip fracture.

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            Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures.

            During the past 10 years, there has been a worldwide effort in all medical fields to base clinical health care decisions on available evidence as described by thorough reviews of the literature. Hip fractures pose a significant health care problem worldwide, with an annual incidence of approximately 1.7 million. Globally, the mean age of the population is increasing, and the number of hip fractures is expected to triple in the next 50 years. One-year mortality rates currently range from 14% to 36%, and care for these patients represents a major global economic burden. Surgical options for the management of femoral neck fractures are closely linked to individual patient factors and to the location and degree of fracture displacement. Nonsurgical management of intracapsular hip fractures is limited. Based on a critical, evidence-based review of the current literature, we have found minimal differences between implants used for internal fixation of displaced fractures. Cemented, unipolar hemiarthroplasty remains a good option with reasonable results. In the appropriate patient population, outcomes following total hip arthroplasty are favorable and appear to be superior to those of internal fixation.
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              The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen.

              Because of the increasing number of elderly people in the United States, the total number of hip fractures in persons 50 years and older will rise from 238,000 to 512,000 by the year 2040, with a concomitant increase in avoidable deaths, disability, and medical costs. The total annual cost of hip fractures (in 1984 dollars) will increase from approximately 7.2 billion dollars currently to 16 billion dollars in the year 2040. Universal use of estrogen therapy by postmenopausal white women may slow but not prevent this rise in hip fractures. New, effective, and widely applicable strategies to prevent hip fractures are urgently needed.
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                Author and article information

                Journal
                Am J Case Rep
                Am J Case Rep
                amjcaserep
                The American Journal of Case Reports
                International Scientific Literature, Inc.
                1941-5923
                2012
                08 February 2012
                : 13
                : 22-25
                Affiliations
                [1 ]Department of Orthopedic Surgery, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
                [2 ]Department of Orthopedic Surgery, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
                [3 ]Cancer Research Center, Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
                Author notes
                Author’s address: Mehrdad Taghipour, Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran, PO. Box: 48178-44718, e-mail: mehrdadtaghipour@ 123456gmail.com
                Article
                882472
                10.12659/AJCR.882472
                3616177
                23569478
                34f9c0fa-d5d4-4d97-a3f6-839e47c4ec6b
                © Am J Case Rep, 2012

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

                History
                : 08 November 2011
                : 20 December 2011
                Categories
                Case Report

                femoral neck fracture,non-displaced fracture,non-operative treatment

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