Femur boyun kırığı

Özet

Femur boyun kırığı, özellikle düşük enerjili düşme sonrası yaşlı hastalarda; genç erişkinde ise yüksek enerjili travmada görülür ve intrakapsüler yerleşimi nedeniyle femur başı dolaşımını etkileyebilir. İnce kesit kontrastsız BT, kortikal basamaklanmayı, trabeküler kesintiyi ve fragman hizasını göstererek kırık morfolojisini tanımlar. Grafiler normalken klinik kuşku sürüyorsa BT'de görünmeyen trabeküler veya inkomplet kırık olabileceği akılda tutulur. Kırığın gözden kaçması yer değiştirme ve femur başı komplikasyonları riskini artırabilir.

Faz ve pencere

Kontrastsız tanısal

Femur boyun kırığında BT, kırık örüntüsünü daha iyi anlamak için kullanılabilir.

Kemik algoritması tanısal

Üç boyutlu bilgisayarlı tomografi ve çok planarlı rekonstrüksiyonlar, kırık hattının boyundan trokanterlere uzanımını ve indirgenme zorluğunu değerlendirmek için kullanışlıdır.

Önerilen pencereler: Kemik (G 1800 / M 400).

BT bulguları

• Subkapital kırık — hat femur başı-boyun bileşkesinden geçer; eklem kapsülü içindedir.
• Transservikal kırık hattı femur boynunun gövdesinde yer alır ve damarsal hasar riski subkapital kırıklara kıyasla moderahtir.
• Baziservikal kırık boyun tabanında yer alır ve femur başı perfüzyonuna en az zararı veren kırık tipidir ancak kendi içinde biyomekanik olarak kararsızdır.
• Kortikal/trabeküler kesinti — ince oblik lusent çizgi, korteks basamağı veya trabeküler hizalanma kaybı.
• Deplasman — baş-boyun ekseni ile proksimal femur şaftı arasındaki uyum bozulur; varus, valgus, rotasyon veya kısalma eşlik edebilir.
• Valgus pozisyonunda impakte femur boyun kırıklarında anatomik restorasyon klinik açıdan güç olabilir.

Ölçütler ve sınıflamalar

Garden

Garden sınıflamasına göre: I tip minimal yer değiştirmeli; II tip kas çekimine bağlı ileri yer değiştirmeli; III tip kısmi yer değiştirmeli; IV tip tam yer değiştirmeli kırık.

AO/OTA femur boyun (31-B)

31-B1: subkapital; 31-B2: transservikal; 31-B3: baziservikal femur boyun kırığı.

Normalde

Aynı tarafta baş-boyun eksenini, üst ve alt korteksin sürekliliğini ve karşı kalçadaki eş düzey kortikal konturları kıyaslayın.

Ayırıcı tanı

Femur başı kırığı

eklem yüzünde, çoğu kez fovea capitis düzeyine göre konumlanan osteokondral fragman vardır.

Normal kemik iliği kanalı kırık hattı taklit edebilir; radyografik özelliklerinin bilinmesi yanlış yorumu önler.

Tuzaklar

• İlk günlerde BT'de seçilmeyen inkomplet veya trabeküler kırık olabilir; devam eden travma kuşkusunda negatif BT'yi kesin dışlama saymayın.
• Besleyici damar kanalına bağlı radyolüsent çizgi eksik kırık hattını taklit edebilir; tanıyı doğrulamak için kontralateral görüntüleme veya BT kullanılır.
• Baziservikal femur boyun kırıkları biyomekanik açıdan kararsız olabilir.

Kendini dene

1. Düşme sonrası kalça ağrısında koronal BT'de femur boynunu çaprazlayan kortikal basamak ve baş-boyun ayrışması görülüyor. En olası kırık hangisi?

   • Femur boyun kırığı
   • İntertrokanterik kırık
   • Asetabulum kırığı
   • Femur başı kırığı
   Cevabı göster

   Femur boyun kırığı. Hat femur boynunun içindedir. İntertrokanterik kırık trokanterler arasında, asetabulum kırığı yuva kemiklerinde, femur başı kırığı eklem yüzünde yer alır.

2. Grafileri normal ancak travma sonrası yük veremeyen hastanın erken kontrastsız BT'si kırık göstermiyor. Hangi yorum doğrudur?

   • İnkomplet kırık yine olabilir
   • Kırık kesin dışlanmıştır
   • Kontrastlı faz zorunludur
   • Pipkin sınıfı belirlenir
   Cevabı göster

   İnkomplet kırık yine olabilir. Erken veya trabeküler inkomplet femur boyun kırığı BT'de görünmeyebilir. Negatif BT tek başına klinik kuşkuyu ortadan kaldırmaz; kontrast fazı kemik kırığını ortaya çıkarmak için gerekli değildir, Pipkin femur başı kırıklarını sınıflar.

İlgili konular

• Femur başı kırığı (Pipkin)

Kaynaklar

Bu sayfadaki 35 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 12 cümle bu karşılaştırmada düzeltildi (2026-10-08).

1. Chinese expert consensus on the surgical treatment of femoral neck fracture by direct anterior approach hip arthroplasty for elderly patients (2025 edition)pmc.ncbi.nlm.nih.gov
2. Expert Consensus on Vascular Assessment and Treatment Strategies for Adult Femoral Neck Fracturespmc.ncbi.nlm.nih.gov
3. Core decompression combined with allogeneic fibular grafting for refractory transient osteoporosis of the hip: a case report and literature reviewpmc.ncbi.nlm.nih.gov
4. Femoral neck fracture after femoral head necrosis: a case report and review of the literaturepmc.ncbi.nlm.nih.gov
5. Methods to predict osteonecrosis of femoral head after femoral neck fracture: a systematic review of the literaturepmc.ncbi.nlm.nih.gov
6. Advanced MRI Techniques for the Hip Joint: Focus on the Postoperative Hip.pubmed.ncbi.nlm.nih.gov
7. Hip dislocations--epidemiology, treatment, and outcomes.pubmed.ncbi.nlm.nih.gov
8. Young femoral neck fractures: are we measuring outcomes that matter?pubmed.ncbi.nlm.nih.gov
9. Abductor tendon tears of the hip: evaluation and management.pubmed.ncbi.nlm.nih.gov
10. Femoral neck fractures after removal of hardware in healed trochanteric fractures.pubmed.ncbi.nlm.nih.gov
11. Femoral Neck Fractures in Children: Issues, Challenges, and Solutions.pubmed.ncbi.nlm.nih.gov
12. Acute hip pain: mimics of a femoral neck fracture.pubmed.ncbi.nlm.nih.gov
13. [Diagnostic imaging and classification of proximal femoral and tibia fractures in adults].pubmed.ncbi.nlm.nih.gov
14. Special topic: Ipsilateral femoral neck and shaft fractures--does evidence give us the answer?pubmed.ncbi.nlm.nih.gov
15. Traumatic Tricuspid Valve Rupture after Blunt Chest Trauma - A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
16. Surgical treatment and prognosis of acetabular fractures associated with ipsilateral femoral neck fractures.pubmed.ncbi.nlm.nih.gov
17. Intra-articular loose body caused by avascular necrosis of the femoral head in children.pubmed.ncbi.nlm.nih.gov
18. Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review.pubmed.ncbi.nlm.nih.gov
19. Bilateral femoral neck stress fractures in elderly individuals: A case report and literature review.pubmed.ncbi.nlm.nih.gov
20. Case Report: Proximal femoral valgus osteotomy and dynamic hip screw fixation for post-traumatic coxa vara secondary to femoral neck or intertrochanteric fracture nonunion or malunion: a retrospective case series.pubmed.ncbi.nlm.nih.gov
21. A novel treatment for the fixation of displaced femoral neck fractures in young patients: A case report.pubmed.ncbi.nlm.nih.gov
22. Intramedullary fixation versus arthroplasty in the treatment of geriatric trochanteric fractures: a systematic review and meta-analysis.pubmed.ncbi.nlm.nih.gov
23. Central and peripheral areal BMD, bone microarchitecture, and strength after initiation of androgen deprivation therapy in men with prostate cancer: a two-year follow-up study.pubmed.ncbi.nlm.nih.gov
24. Delayed Diagnosis of an Occult Femoral Neck Fracture Undetected by MRI and Dual-Energy CT: A Case Report.pubmed.ncbi.nlm.nih.gov
25. Subject-Specific Finite Element Analysis of the Human Femur Using Radiation-Free Three-Dimensional Zero-Echo-Time Magnetic Resonance Imaging (3D ZTE MRI): A Feasibility Study.pubmed.ncbi.nlm.nih.gov
26. Posterior Acetabular Wall Fracture Mimicking a Subcapital Femoral Neck Fracture on Plain Radiographs: A Diagnostic Pitfall and the Role of Intraoperative Fluoroscopy: A Case Report.pubmed.ncbi.nlm.nih.gov
27. A Systematic Approach to the Evaluation of Acute Musculoskeletal Injuries in the Emergency Department.pubmed.ncbi.nlm.nih.gov
28. Imaging of pediatric musculoskeletal trauma: Age-specific considerations and challenges.pubmed.ncbi.nlm.nih.gov
29. Interlocking plate compared with conventional pin fixation for undisplaced femoral neck fractures: a randomized controlled trial with radiostereometric analysis.pubmed.ncbi.nlm.nih.gov
30. The Unique Features of Pediatric Sports Injuries: The Hip.pubmed.ncbi.nlm.nih.gov
31. Conservative Treatment of Pediatric Fractures-Narrative Review of Acceptable Deformity and Remodeling Potential.pubmed.ncbi.nlm.nih.gov
32. Quantitative contrast enhanced dual energy CT to predict avascular necrosis: a feasibility study of proximal humerus fractures.pubmed.ncbi.nlm.nih.gov
33. Case Report: Total hip arthroplasty via the direct anterior approach using a cementless revision stem without corrective osteotomy for fibrous dysplasia.pubmed.ncbi.nlm.nih.gov
34. A Case Report of Pipkin Type II Femoral Head Fracture Managed by Ganz Safe Surgical Dislocation and Headless Compression Screw (Herbert Screw) Fixation: A Stepwise Technical Description and Clinical Outcome.pubmed.ncbi.nlm.nih.gov
35. Which trajectory should we choose? - Defining safe entry-target pathways and underlying femoral morphology for bone marrow injection in osteonecrosis of the femoral head.pubmed.ncbi.nlm.nih.gov
36. Peri-Implant Subcapital Femur Fracture Post Cephalomedullary Nail Fixation.pubmed.ncbi.nlm.nih.gov
37. Proximal femoral morphometry and its association with hip fracture patterns: a systematic review with meta-analysis.pubmed.ncbi.nlm.nih.gov
38. Fixation failure following femoral neck system fixation for intracapsular femoral neck fractures: Association with fracture orientation.pubmed.ncbi.nlm.nih.gov
39. Biomechanical Study of the Preventive Effect of Different Cephalomedullary Fixation Methods on the Occurrence of Femoral Neck Fractures in Osteoporotic Femurs.pubmed.ncbi.nlm.nih.gov
40. Intertrochanteric Fracture Secondary to Solitary Osteochondroma: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
41. Lateral Femoral Neck and Peritrochanteric Fractures: Anatomical Classifications and Pre-Operative Reduction Techniques-A Narrative Review.pubmed.ncbi.nlm.nih.gov
42. Liver transplantation-related osteoporosis and fragility fractures: pathogenic pathways, risk stratification and novel targeted therapy advances.pubmed.ncbi.nlm.nih.gov
43. Internal-locking intramedullary nails (talons, claws, wings, wedge-locks, endopins): a mechanics-guided scoping review of designs, failure signatures, and technique imperatives.pubmed.ncbi.nlm.nih.gov
44. Atraumatic anterior hip dislocation after cephalomedullary nailing for an intertrochanteric femoral fracture: a case report highlighting the importance of initial reduction and prevention of excessive telescoping.pubmed.ncbi.nlm.nih.gov
45. A novel classification system based on the lateral view of 3D-CT for predicting the reducibility of intertrochanteric fractures: a retrospective study.pubmed.ncbi.nlm.nih.gov
46. Association of Long Versus Standard-Length Cephalomedullary Nail Constructs with Posterior Sagging in Intertrochanteric Fractures with Posteromedial Comminution: A Retrospective Comparative Study.pubmed.ncbi.nlm.nih.gov
47. Proximal femoral fractures in children: incidence, complications, and functional outcomes-a population-based study from Finland.pubmed.ncbi.nlm.nih.gov
48. Surgical fixation of ipsilateral femoral neck and shaft fractures: a matter of debate?pubmed.ncbi.nlm.nih.gov
49. Screening performance of sternal CT attenuation for opportunistic osteoporosis.pubmed.ncbi.nlm.nih.gov
50. Knee-specific bone quality assessment for cementless total knee arthroplasty candidate selection: a narrative review.pubmed.ncbi.nlm.nih.gov
51. Anatomy-driven automated subsegmentation of pelvic and proximal femoral CT into clinically relevant subregions and landmarks.pubmed.ncbi.nlm.nih.gov
52. Comparison of clinical efficacy and psychological outcomes of femoral neck system combined with rhBMP-2 for young adult femoral neck fractures.pubmed.ncbi.nlm.nih.gov
53. Superior reduction quality without improved outcomes: open versus closed reduction for displaced femoral neck fractures in adults under 60 years.pubmed.ncbi.nlm.nih.gov
54. A Novel Scoring System Can Estimate the Risk of Posttraumatic Osteonecrosis After Femoral Neck Fracture Fixation in Adults Younger Than 65 Years.pubmed.ncbi.nlm.nih.gov
55. Characteristics of the Extent and Onset of Osteonecrosis of the Femoral Head After Femoral Neck System (FNS) Fixation: A Minimum Two-Year Follow-Up Comparative Study with Cannulated Screws.pubmed.ncbi.nlm.nih.gov
56. Clinical efficacy of manual reverse closed reduction and robot-assisted cannulated screw fixation for valgus-impacted osteoporotic femoral neck fractures in the elderly: a retrospective cohort study.pubmed.ncbi.nlm.nih.gov
57. Femoral Neck Fracture With Anterior Tilt.pubmed.ncbi.nlm.nih.gov
58. Outcomes for an Alternative Technique of In Situ Screw Fixation for Garden I and II Femoral Neck Fractures.pubmed.ncbi.nlm.nih.gov
59. A comparative study on the clinical efficacy and complications of proximal femoral nail antirotation and femoral neck system in the treatment of basicervical femoral neck fracture (AO/OTA 31-B3).pubmed.ncbi.nlm.nih.gov
60. Intramedullary Femoral Nailing-Blade Versus Screw: A Risk Analysis of Implant-Related Complications in Trochanteric Femoral Fractures.pubmed.ncbi.nlm.nih.gov
61. What is the rate and degree of deformity in femoral diaphyseal nonunion? A CT-based retrospective cohort study.pubmed.ncbi.nlm.nih.gov
62. A novel figure-of-eight polymeric cerclage wiring technique for greater trochanter fixation in revision arthroplasty and conversion of failed proximal femur fracture fixations to total hip arthroplasty.pubmed.ncbi.nlm.nih.gov
63. Functional Outcomes of Valgus Osteotomy in Young Patients of Intracapsular Neck of Femur Fracture: A Case Series.pubmed.ncbi.nlm.nih.gov
64. Does Cephalomedullary Nail Design Influence Risk of Varus Collapse in Subtrochanteric Femur Fractures?pubmed.ncbi.nlm.nih.gov
65. Does the distal screw location in the Biplane double-supported screw fixation technique affect the risk of subtrochanteric fractures after femoral neck fixation? A finite element analysis.pubmed.ncbi.nlm.nih.gov
66. Biomechanical advantages of double-column bridging plate-augmented PFNA for complex subtrochanteric femoral fractures: a finite element analysis.pubmed.ncbi.nlm.nih.gov
67. Femoroacetabular stabilization using a suspensory fixation device in post-traumatic hip instability after hip fracture-dislocation: technique and report of 6 cases.pubmed.ncbi.nlm.nih.gov
68. Hip Arthroscopy-Assisted Management of Pipkin Types I and II Femoral Head Fracture-Dislocations: Mid-Term Clinical and Radiographic Outcomes.pubmed.ncbi.nlm.nih.gov
69. Regional distribution of microvasculature within the canine femoral head: a study of plastinated tissue histology and 3D reconstruction.pubmed.ncbi.nlm.nih.gov
70. Differentiating Sciatica from Hip Osteoarthritis: Diagnostic Challenges and the Role of the Athena Sign.pubmed.ncbi.nlm.nih.gov
71. Osteoarthritis: Epidemiology, Diagnosis, and Treatment.pubmed.ncbi.nlm.nih.gov
72. 3D-printed hip prostheses with regenerative integration: a state-of-the-art comprehensive review.pubmed.ncbi.nlm.nih.gov
73. Padua Days on Muscle and Mobility Medicine, March 25-29, 2025, Hotel Petrarca, Euganean Thermae, Italy: Program and Abstracts.pubmed.ncbi.nlm.nih.gov
74. American Thyroid Association Guide to investigating thyroid hormone economy and action in rodent and cell models.pubmed.ncbi.nlm.nih.gov
75. High-affinity alphavbeta3 integrin targeted optical probe as a new imaging biomarker for early atherosclerosis: initial studies in Watanabe rabbits.pubmed.ncbi.nlm.nih.gov
76. Occult femoral neck fractures in ipsilateral femoral shaft and patellar fractures: A case series about diagnostic challenges and proposed strategies.pubmed.ncbi.nlm.nih.gov
77. Development and validation of a deep learning-based automatic detection and classification model for femoral neck fractures using hip imaging: a retrospective multicenter diagnostic study.pubmed.ncbi.nlm.nih.gov
78. Musculoskeletal infections through direct inoculation.pubmed.ncbi.nlm.nih.gov
79. Radiologic Mimics of Osteomyelitis and Septic Arthritis: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
80. MRI nomenclature for musculoskeletal infection.pubmed.ncbi.nlm.nih.gov
81. Expert Consensus on Vascular Assessment and Treatment Strategies for Adult Femoral Neck Fractures.pubmed.ncbi.nlm.nih.gov
82. Subcapital Femoral Fracture with Cephalomedullary Nail Lag Screw Failure after Healed Intertrochanteric Fracture: A Case Report.pubmed.ncbi.nlm.nih.gov
83. Application value of auxiliary anterolateral hip mini-incision combined with traction-free reduction and internal fixation in complex intertrochanteric fractures in older adult patients.pubmed.ncbi.nlm.nih.gov
84. Japan's contributions to hip joint preservation and reconstruction: from osteonecrosis and developmental dysplasia to precision arthroplasty.pubmed.ncbi.nlm.nih.gov
85. Optimizing diagnosis and management of ONFH, FNSF, and SIF.pubmed.ncbi.nlm.nih.gov
86. Predicting femoral neck screw pullout strength using DXA and novel assessments of bone microarchitecture.pubmed.ncbi.nlm.nih.gov
87. Progress of fracture mapping technology based on CT three-dimensional reconstruction.pubmed.ncbi.nlm.nih.gov
88. Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis.pubmed.ncbi.nlm.nih.gov
89. Slipped capital femoral epiphysis: a review of management in the hip impingement era.pubmed.ncbi.nlm.nih.gov
90. Super-acute massive osteolysis of the femoral head after acetabular fracture fixation : a comparative study with conventional post-traumatic osteonecrosis requiring total hip arthroplasty.pubmed.ncbi.nlm.nih.gov
91. Catastrophic Failure of a Prosthetic Femoral Stem due to Component Malposition: A Case Report.pubmed.ncbi.nlm.nih.gov
92. CT-based micromotion analysis for tracking fracture displacement and fragment movement in trochanteric hip fractures: an agreement study.pubmed.ncbi.nlm.nih.gov
93. Invited Perspective: It is Time to Rename SCFE.pubmed.ncbi.nlm.nih.gov
94. Intra-articular Osteoid Osteoma of the Femoral Neck Mimicking Inflammatory Hip Disease: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
95. Nutrient Artery Canal of Femur Masquerading a Fracture Line: A Case Report.pubmed.ncbi.nlm.nih.gov
96. Advances in the mechanism for steroid-induced osteonecrosis of the femoral head.pubmed.ncbi.nlm.nih.gov
97. Ultrasound and bone: a pictorial review.pubmed.ncbi.nlm.nih.gov
98. Glossary of terms for musculoskeletal radiology.pubmed.ncbi.nlm.nih.gov
99. Commentary: an eye on PET quantification.pubmed.ncbi.nlm.nih.gov
100. Bone-Sparing Hip Arthroplasty in Young and Active Patients: A Narrative Review.pubmed.ncbi.nlm.nih.gov
101. A 50-year perspective on the use and potential of artiodactyl calcanei in bone adaptation studies.pubmed.ncbi.nlm.nih.gov
102. Insights into Vascular Changes in Hip Degenerative Disorders: An Observational Study.pubmed.ncbi.nlm.nih.gov
103. Potential therapeutic applications of stem cells in animal models of ocular affections.pubmed.ncbi.nlm.nih.gov
104. Nucleic acid aptamers in orthopedic diseases: promising therapeutic agents for bone disorders.pubmed.ncbi.nlm.nih.gov
105. Paleohistology of Caraguatypotherium munozi (Mammalia, Notoungulata, Mesotheriidae) from the early late Miocene of northern Chile: A preliminary ontogenetic approach.pubmed.ncbi.nlm.nih.gov
106. A Plea for a Paradigm Shift from X-Ray to Ultrasound in Adults: An Update for Emergency Physicians, General Practitioners, Orthopedists and Sports Medicine Physicians.pubmed.ncbi.nlm.nih.gov
107. Anatomy of the intraosseous arterial microvasculature of the adult lumbar vertebral body and its role in fracture healing: a literature review and historical perspective.pubmed.ncbi.nlm.nih.gov
108. FracDet-v11: a multi-scale attention and wavelet-enhanced network for real-time pediatric wrist fracture detection.pubmed.ncbi.nlm.nih.gov
109. An Acta Orthopaedica educational article: Femoral neck fractures in adults with emphasis on surgical treatment.pubmed.ncbi.nlm.nih.gov
110. Does Preoperative CT Improve Outcomes in Femoral Neck Fracture Fixation? A Retrospective Study.pubmed.ncbi.nlm.nih.gov
111. Peri-Implant Fracture Following Prior Fixation of Femoral Neck Fracture Using the Femoral Neck System: A Case Report.pubmed.ncbi.nlm.nih.gov
112. Total hip replacement versus bipolar femoral head replacement for femoral neck fractures in the elderly: effect on surgical indices, hip function, and postoperative complications.pubmed.ncbi.nlm.nih.gov
113. How do forelimb long bones adapt in rhinoceroses? An in-depth examination of their microanatomy.pubmed.ncbi.nlm.nih.gov
114. New insights on femoral head trabecular bone directionality in elderly humans using a micro-CT-based analysis.pubmed.ncbi.nlm.nih.gov
115. Proximal femoral nail anti-rotation with and without cable cerclage for intertrochanteric femoral fractures with vulnerable lateral wall: a retrospective cohort study.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez. İçerik yapay zekâ destekli bir süreçle güncel literatüre göre cümle cümle kaynaklarla karşılaştırıldı, ancak uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.