LATE END RESULTS IN UNUNITED FRACTURE OF THE NECK OF THE FEMUR TREATED BY THE BONE PEG OR THE RECONSTRUCTION OPERATION

The end results in 146 cases of ununited fracture of the neck of the femur were reviewed. Five were seen early, and treated with the Whitman abduction spica with excellent result. Thirteen cases had to be eliminated because of incomplete records. In forty-two of the remaining 128 cases, the bone peg operation was recommended; in fifty-three, the reconstruction operation. Six of the former refused operation, and nine of the latter, leaving a total of eighty patients operated on (thirty-six bone peg and forty-four reconstruction).

In ninety per cent. of the bone-peg operations the results were excellent or good, and in seventy-five per cent. of the reconstruction operations. The interval between the time of operation, and that of the last examination varied from a few months to fifteen years. Function is usually good within six months after operation. When we consider that ununited fracture of the neck of the femur is one of the most disabling of all traumatic lesions, and one of the most difficult problems in surgery because of the anatomicomechanical conditions and because of the erosion that has so often taken place before the surgeon is consulted, such end results are most encouraging.

Failure to take x-rays at the time of the accident, or the taking of x-rays in only one position accounts for many unfortunate cases of delay in correct diagnosis and treatment. The greater this delay, the greater the difficulty of the problem with which the surgeon is eventually confronted.

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