Femoral Neck fracture Classifications - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes fracture classifications of the femoral neck.
Garden classification
Type I
Incomplete and impacted in valgus
Type II
Fracture is complete and nondisplaced on at least two planes (anterior & lateral).
Type III
Complete fracture and partially displaced
Trabecular pattern of the femoral head does not line up with the acetabular trabecular pattern.
Type IV
Completely displaced with no continuity between the proximal and distal fragments
Pauwel’s classification
There are three fracture types within Pauwel’s classification:
Type I
Type I has an obliquity ranging from 0 to 30 degrees.
Type II
Type II has an obliquity ranging from 30 to 50 degrees
Type III
Type III has an obliquity of 70 or more degrees.
The more vertical orientation of the fracture, the higher the risk of nonunion and osteonecrosis.
The more displaced the fracture, the more disruption of the blood supply and chance of avascular necrosis and nonunion.
Avascular necrosis may occur in 20-25% of displaced fractures.
Nonunion may occur in about 25% of displaced fractures.
Treatment
Nondisplaced fracture
Screw fixation
Nondisplaced fracture may become displaced
Important to fix the fracture emergently in young patients before the fracture becomes displaced.
Displaced fracture-younger patients EMERGENCY
Do closed reduction and screw fixation
If closed reduction fails, do open reduction and screw fixation utilizing the Watson Jones approach.
Displaced fracture older patients
Screw fixation in the elderly has a higher incidence in failure of fixation and reoperation. Do not do screw fixation.
High functional demand patient
Do total hip arthroplasty
Total hip is the procedure of choice especially if there is pre-existing rheumatoid or degenerative arthritis.
Higher dislocation rate.
Elderly low demand patient
Unipolar or bipolar
Cemented or uncemented
In rare cases, excision of the femoral head can provide alternative in high-risk patients.
Nonunion
Do subtrochanteric osteotomy in younger patients.
Do prosthesis in older patients
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[@kalpeshpatel1]

good one sir. this helps me in my revision during my exam. gives me nice and basic, clear idea. thank you

[@Demitchii]

Your videos are much appreciated. Thanks.

[@hemanthajare7]

Thank you Dr. Nabil for taking out your time and making this educational video.
I am from India and I have undergone my DHS surgery recently.
Thanks again.

[@MeryoumaDZ]

Very helpful, thank you so much Dr Braheim !!

[@user-ln9cm8ry6f]

just amaising . thanks a lot

[@learnteach2learn729]

Great video Dr, thanks

Thank you! very helpful

[@Christina-dm9pv]

Very helpful, thank you.

[@belatube3096]

very help full.thank u

[@yunpeng6569]

very helpful!

[@subbukannubalaravindran4496]

I have a slight doubt in your video on vertical fracture and subtrochanteric osteotomy. In this video you have shown after osteotomy the proximal fragment is pulled down and aligned with femur shaft. In reality we abduct the femur shaft and align it with the proximal fragment and that is why it is called Abduction Valgization osteotomy. Am I correct? And can you throw some light how exactly that abduction is done during surgery?

[@nibraham]

Great Video

[@nabilebraheim]

@anandvich thanks

[@user-jh6fd1gv2b]

Thank you

[@sarmadidress8238]

thanx dr

[@tulsiramneopaney1077]

Thanks for the video.It helps me a lot.

[@rix908]

own .
.

[@ishfaqahamad1243]

Hip joint surgery Ka bad kitna time Mai thik hota hai

[@nabilebraheim]

@nibraham thanks

[@aimenattoui1328]

Thank you sir :)

[@navneet0904]

How shall we approach a non displaced fracture in elderly person 30 to 50 degree?

[@nabilebraheim]

@orthopassion thanks

[@nabilebraheim]

@astramov thanks

[@shivaaryal7974]

hlw dr, i want to know if the type II of this classification (Pauwel's) of fracture is from 30 to 50 or it is 30 to 70. i will be glad to hear from you

[@doctorroysmith8408]

thnx sir

[@MissWooHoo11]

i got a number 3 in my wrist last night when i drank too much and was practicing karate moves on my friends! damn it hurts so bad today!

[@sayakmohn]

Thanks Dr Braheim

[@vissisingh7832]

my grandfather has gone hospital for surgery today and he is 65 year old he is suffering from type 3rd femoral neck fracture

[@tanvincent4596]

my mum should have do total hip arthroplasty for the initial operation instead of subtrochanteric osteotomy.

[@surarahman6864]

why withuot your sound dr ?? thanks

[@jessicagraca2755]

I was trying to find any comment with the sound fr HHAHAHHAHAHA

[@TheVishu27]

please remove last part saying all videos for educational purposes.. ..