Prediction of Necrosis Avascular Femoral Head after Femoral Neck Fractures Based on Bleeding During Surgery with Drilling Methods

Bleeding from proximal screw drill-site in femoral neck fractures may have the ability to predict the occurance of avascular necrosis of femoural head. In this study the relationship of bleeding from proximal screw drill-site during internal fixation of femoral neck fractures with rate of avascular necrosis was studied. This study is a cross-sectional study that was carried out on 19 to 60 year patients with femoral neck fracture that referred to health care centers in Rasht، Iran during the year 2008. The age، sex، type of fracture based on Garden Category were recorded. Then، presence or absence of bleeding from the proximal screw holes within the first 5 minutes was recorded. In this study، 40 patients were enrolled with mean age of 39. 78±14. 4. Twenty two patients (55%) had bleeding from the proximal end of the screw، and 18 (45%) did not have any bleeding. Bleeding from proximal screw hole in patients without avascular necrosis was seen in 11 cases (61. 1%). This difference was statistically significant (p=. 005). Presence of bleeding from proximal screw hole in femoral neck fracture reduces odds of AVN in femoral head fracture and can help deciding between internal fixation or arthroplasty for treatment of such a fracture.