Quick diagnosis of non-displaced fracture of the femoral neck: A case report

Non-displaced fractures of the femoral neck in the elderly are serious injuries. They may not be evident on initial radiographs due to overlying soft tissue, osteopenia, or radiographic techniques. Delay in diagnosis can increase associated medical, economic, and legal implications in the changing health care environment, since displacement can lead to avascular necrosis of the femoral head, nonunion, or varus deformity. Early and accurate detection can enable physicians to perform relatively simple surgical fixations in situ. Refinements in diagnosis can improve outcomes and minimize the duration of hospital stays. Traditionally, bone scans and magnetic resonance imaging (MRI) have been used for early detection of non-displaced femoral neck fractures. The disadvantages of these examination techniques include exposure to radiation and high costs, respectively. Initial radiographs of elderly patients were equivocal, but clear fracture lines were demonstrated after retaking the films while keeping the ipsilateral foot internally rotated at 30 degrees. This simple radiographic technique can enhance radiographic diagnosis of this elusive entity.