Femoral neck fractures after poliomyelitis

After the last great polio epidemic in 1957/58 we treated during the ensuing 15—20 years approximately 20 neck fractures in polio patients in our institute. Since then neck fractures in polio patients have only been observed sporadically (only two in

1998). We would like to submit our experience gained over decades: the femoral neck fracture of the atrophic limb is less displaced, most probably due to the muscle weakness. For the same reason a distraction of the fracture often occurs during reduction (see Fig. 175). Two screws give sufficient stability in the small bone. The healing potential of these fractures is excellent. Serious head necroses were not seen in any of the followed up patients. We believe that this is the consequence of the reduced pressure exerted on the femoral head as the atrophic muscles cannot pro

Poliomyelitis

Fig. 233. Femoral neck fracture after poliomyelitis.

This 65-year-old woman had polio as a child. She was able to walk with two canes and fell on the day of admission; a, b. Left Garden-IV neck fracture; c, d. Stabilization with cannulated screws in valgus position, distraction and over rotation. Eight days later the fracture gap has closed after mobilization; e, f. Three years later the fracture has healed, the femoral head is spherical and the joint space preserved

Fig. 233. Femoral neck fracture after poliomyelitis.

This 65-year-old woman had polio as a child. She was able to walk with two canes and fell on the day of admission; a, b. Left Garden-IV neck fracture; c, d. Stabilization with cannulated screws in valgus position, distraction and over rotation. Eight days later the fracture gap has closed after mobilization; e, f. Three years later the fracture has healed, the femoral head is spherical and the joint space preserved duce any force. Should a partial necrosis occur, it will not lead to a head collapse. As a rule the young bone has sufficient time to regenerate (Fig. 233).

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