DIFFICULT FRACTURES OF THE NECK OF THE FEMUR TREATED WITH THE STUD-BOLT SCREW

Simplification of Technique

¹ Professor of Orthopaedic Surgery, University of São Paulo, Brazil

1. A series of end results of the treatment with the stud-bolt screw of some particularly unfavorable cases of fracture of the neck of the femur is presented.

2. The technique and the instruments for the osteosynthesis have been greatly simplified since the author's first description.

3. A hand drill is used instead of the electric motor, and very few special instruments are required, thus making the operation practicable for more surgeons.

4. Eight cases, selected from a series of eighty operations, are reported to demonstrate that, even under particularly unfavorable conditions, union and good function may be obtained with the stud-bolt screw.

5. Two cases of non-union, one of nine and one of sixteen months' duration, are reported, in which union and perfect function have been obtained by the association of osteosynthesis and osteotomy in the same operation.

6. The good results in these difficult cases are attributed to the solidity of the osteosynthesis, and to the strong impaction produced by the stud-bolt screw.

7. A short plaster cast, leaving the knee free, is now usually applied about twenty days after the operation, when the patient begins to walk. This is removed after forty days.

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