ABSTRACT
A fractured neck of the femur is increasingly common due to the aging population, more common in women than in men and more common in whites. The blood supply of the femoral head comes from three main sources: the medial femoral circumflex artery, the lateral femoral circumflex artery and the obturator artery. Capsulotomy in femoral neck fractures remains a controversial issue, and the practice varies by trauma programme, region and country. Clinical studies show that decompressing the intracapsular haematoma via capsulotomy or aspiration reduces the intracapsular pressures. Cannulated screw fixation is more commonly used in nondisplaced transcervical fractures in healthy young patients. A minimum of three 6.5 mm cancellous screws are used. Hemiarthroplasty can be done with unipolar or bipolar prosthesis. Bipolar prosthesis has the advantage of movement at two interfaces, thereby reducing the acetabular wear. Osteosynthesis can also be done using a muscle pedicle graft, thereby increasing the blood supply to the fracture site to promote healing.
