Femoral neck fractures in young patients are mostly seen after high-energy trauma. Internal fixation methods are the gold treatment choice in young, healthy, and active patients with good bone quality. [1] Potential complications after trauma and surgery make the treatment of these fractures more challenging. Various surgical methods and fixation options have been proposed for the surgical treatment of femoral neck fractures. [2] Anatomic reduction is the most important factor in internal fixation of femoral neck fractures. The time to surgery (from trauma to operating theatre), capsulotomy, and the implant choices are controversial in the literature. [3] Many types of implants are used for internal fixation of femoral neck fractures. [3] Osteosynthesis with cannulated screws (CSs) and dynamic hip screws (DHSs) are the most commonly used modalities. [4] Although internal fixation of femoral neck fractures provides blood flow to the femoral neck, complications such as non-union and avascular necrosis (AVN) are still seen in 10-20% and 10-30% of cases, respectively. [5,6] In addition, joint replacement is performed in 20-36% of these Objectives: This study aims to compare the results of internal fixation with dynamic hip screw (DHS)/antirotation screw and conventional cannulated screw (CS) for femoral neck fracture. Patients and methods: This retrospective study included a total of 78 patients (57 males, 21 females) with collum femoris fractures treated with internal fixation between January 2015 and January 2019. Group 1 comprised 41 patients with a mean age of 45.7 years (range, 19 to 62 years) treated with DHSs/antirotation screws, while group 2 comprised 37 patients with a mean age of 41.9 years (range, 17 to 75 years) treated with CSs. The patients were evaluated for union, avascular necrosis (AVN), femoral neck shortness, operation time, duration of fluoroscopy exposure, and functional outcomes. Results: Age, gender, and Garden classification stages were similar in both groups. No significant difference was found between the groups in respect of AVN and non-union rates. The non-union rate was 12.2% in group 1 and 21.6% in group 2 (p>0.05). The duration of fluoroscopy exposure was statistically significantly higher in group 2 (p=0.001) and the operation time was statistically significantly longer in group 1 (p=0.001). In group 2, femoral neck shortness stature was significantly higher (p=0.007). At the final follow-up examination, the Harris hip score was statistically significantly higher in group 1 (p=0.04). Conclusion: Dynamic hip screw/antirotation screw was a more relevant treatment method for transcervical femoral neck fractures compared to CS with more favorable functional outcomes and less fluoroscopy exposure.

This study aims to analyze the spectrum, management, and outcome of Syrian refugees' fracture over fouryear period, highlighting challenges in management and follow-up. Methods This was a retrospective review of Syrian refugee patients operated for fractures at our centre from January 2015 to January 2019. The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, surgical technique, complications, mortality and morbidity. The comparison of complications and postop outpatient clinic controls between Turkish citizens and Syrian refugees were also evaluated. Results The study included a total of 455 patients comprising 281 adults (202 males, 79 females) with a mean (SD) age of 41.1 (19.3) years and 174 children with a mean age of 8.8 (4.9) years. The trauma mechanism was most commonly fall in both adult and pediatric patients (86.6% / 73.5%). Whilst lower limb fractures were more common in adults (73.7%), upper limb fractures were more common in children (63.4%). The presence of accompanying trauma was determined in 21 (7.5%) adults and 10 (5.7%) children. Multiple fractures were determined in 12 (4.3%) adults and eight (4.6%) children. Plate fixation (PF) was most used in 137 (48.8%) adult patients and K-wire augmentation was used in 75 (43.1%) pediatric patients. Out of the 455 patients, 41 (14.6%) adults and 13 (7.3%) children developed complications. Whilst three adult patients were died during follow-up, no deaths were recorded in the pediatric patients. Complication rate was 54/455 in Syrian refugees and 32/455 in citizens. It was observed that the complication was significantly higher in immigrants (p: 0.017). Sixty-five (14.2%) Syrian immigrants did not come to the outpatient clinic control at all or once, while this rate was 29/455 (6.3%) for Turkish citizens (p = 0.012). Conclusion Inadequate living conditions and lack of communication faced by refugees reduce the rate of patient followup and negatively affect the results of orthopedic trauma.

Objective: Hip fracture is one of the most critical health problems which the orthopaedic surgeons faced in the elderly population. Geriatric hip fractures are common, leading to high mortality and morbidity. The aim of the study is to analyze the current status of hip fractures, global trends, and clinical research status.Methods: Top hundred articles related to the geriatrci hip fractures were taken from the Web of Science Core Collection. Basic information including number of citations, of publication, the authors, title, country , and year journal was extracted. The keywords were visualized using the VOSviewer. Results:After the application of the study criteria, it was observed that there were 591 articles published between 1980-2020. Among the 100 articles, there were totally 7,376 citations. There were averagely 73.76 citations per article. A total of 419 authors, 168 institutes and 23 nations and regions published relevant articles. The most used keywords were hip fracture, mortality, and elderly. Conclusion:In this study , the first 100 articles summarised can help researchers characterise outstanding literature in this field, figure out the history of hip fracture research in the elderly, and plan future research. Geriatric hip fractures result in situations extending far beyond orthopedics that concern many disciplines such as preventive medicine ,epidemiology, endocrinology,internal medicine, gerontology, and critical care. Research, interest, and publications continue to grow.

Background: Femoral neck fracture is a common cause of morbidity in the younger population with potentially poor prognosis and functional results. The purpose of this study was to evaluate how the success of anatomic reduction affects hip functional outcomes by using a new numerical index modified from the Garden index. Methods: Twenty-six patients who underwent closed reduction and internal fixation by means of three cannulated screws due to femoral neck fracture between 2010 and 2014 were scanned retrospectively and included in the study. Harris hip scores of the patients at nine to 12 months were evaluated using the new index modified from Garden which is the sum of the differences from the ideal Garden index calculated on early postoperative anteroposterior and lateral pelvis radiographs. Results: The mean hip score was 73.1 (± 16.4), the minimum score was 32, the maximum score was 93. Postoperative anteroposterior radiographs revealed a mean Garden alignment index of 153.6°, the lowest value was 135° and the highest value was 168°. In the lateral radiographs, the mean Garden alignment index was 173.1°, the lowest value was 160° and the highest value was 178°. The mean value of the novel index was found as 14.2°, the lowest value was 2°, and the highest value was 40°. There was an inverse correlation between the novel index we defined and the Harris hip score (p<0.01). Conclusion: In femoral neck fractures, the success of anatomic reduction is an important factor affecting the patient’s functional outcome. We believe the new reduction index we proposed will contribute to literature comparing the success of reduction in femoral neck fractures.