Experience with the Non-operative Treatment of Impacted Fractures of the Neck of the Femur.

Fractures of the femoral neck are considered to be impacted when they do not displace during normal hip movement. This implies that the fragments are in close apposition so that they move as one. They have received relatively little attention compared with displaced fractures because they have been considered generally to be simple to treat and complicated rarely by non-union and avascular necrosis. Nevertheless the best method oftreatment ofimpacted fracture is still debated. Proponents of conservative treatment point out that because most will unite under proper supervision without internal fixation the hazards involved in operation are not justified in preventing displacement in a small proportion of cases (Linton 1944, Crawford 1960, 1965). In addition, internal fixation may disimpact the fracture or increase the risk of avascular necrosis of the femoral head. Others claim that because impacted fractures often displace spontaneously in