46: Intro to Femoral Neck Fractures w/ Dr. Harrison

Femoral neck fractures require a systematic trauma workup, utilizing AP pelvis and lateral hip imaging to evaluate displacement and fracture patterns. Classification systems like Garden and Pauwels guide treatment, though clinicians must prioritize functional status over chronological age when choosing between internal fixation and arthroplasty. Stable, non-displaced fractures often respond well to percutaneous pinning using an inverted triangle screw configuration, whereas displaced or high-energy fractures frequently necessitate dynamic hip screws or arthroplasty. Optimal implant selection—such as cemented hemiarthroplasty for elderly patients or total hip arthroplasty for active individuals—depends on bone quality and specific patient activity levels. Achieving a minimal tip-apex distance remains critical for preventing implant cutout, while open reduction techniques provide necessary stability in younger patients to preserve the femoral head and minimize the risk of avascular necrosis.