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It has been shown in the past that attempts to correct the slippage by moving the head back into its correct position can cause the bone to die. Therefore the head of the femur is usually pinned 'as is'. A small incision is made in the outer side of the upper thigh and metal pins are placed through the femoral neck and into the head of the femur.
The neck is flattened from before backward, contracted in the middle, and broader laterally than medially. The vertical diameter of the lateral half is increased by the obliquity of the lower edge, which slopes downward to join the body at the level of the lesser trochanter, so that it measures one-third more than the antero-posterior diameter.
Klein's line or the line of Klein is a virtual line that can be drawn on an X-ray of an adolescent's hip parallel to the anatomically upper edge of the femoral neck.It was the first tool to aid in the early diagnosis of a slipped capital femoral epiphysis (SCFE), which if treated late or left untreated leads to crippling arthritis, leg length discrepancy and lost range of motion.
The Garden classification is a system of categorizing intracapsular hip fractures of the femoral neck. This fracture often disrupt the blood supply to the femoral head . British orthopaedic surgeon Robert Symon Garden [ fr ] described a classification system for this type of fracture, referred to as the Garden classification and consisting of ...
The zona orbicularis and proximal hip joint capsule are poorly understood. Recent studies seem to confirm that the proximal to middle part of the articular capsule, including the zona orbicularis, acts biomechanically as a locking ring wrapped around the femoral neck and thus is a key structure for hip stability in distraction.
Proximal femoral fractures usually occur in osteoporotic patients, and their signs include subtle neck angulation, trabecular angulation, and subcapital impaction line. A frog-leg lateral view may be helpful if the greater trochanter is short enough. However, positioning can be difficult because of hip pain.
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Trethowan's sign is when Klein's line does not intersect the lateral part of the superior femoral epiphysis on an AP radiograph of the pelvis. [1] Clinical use