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Arch Surg. 1947;55(1):51-57. doi:10.1001/archsurg.1947.01230080054004.
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MOST surgeons concede that the average case of intracapsular fracture of the neck of the femur still represents a major, and often irretrievable, disaster. Internal fixation of the fresh fracture and various methods of restoration of stability in cases with nonunion have been great advances. The younger group of patients, unfortunately small, usually does well; but, in all fairness, one must admit a high percentage of bad results in the run of cases. The causes of failure in the treatment of fresh fractures of the neck of the femur are well known; they include: (1) inadequate reduction and pinning; (2) degenerated bony structure, which in the aged will not support internal fixation; (3) late aseptic necrosis (or fragmentation) of the head of the femur; (4) degenerative arthritis, with or without bony union, and (5) too early weight bearing on a bad mechanical line subject to shearing force.

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