title: Avascular necrosis and nonunion after osteosynthesis of femoral neck fractures: effect of fracture displacement and time to surgery.
abstract: This study assessed the effect of fracture displacement and elapsed time before surgery on the development of avascular necrosis and nonunion after internal fixation of femoral neck fractures. Twenty-eight patients with 30 femoral neck fractures who underwent internal fixation and completed a minimum of 2 years' follow-up were retrospectively analyzed. The rates of avascular necrosis and nonunion were 12.5% and 25%, respectively, among patients who underwent surgery before 12 hours had elapsed and 14% and 27% among those who underwent surgery after that time. The rates of avascular necrosis and nonunion associated with fracture displacement were 6% and 18%, respectively, among patients with undisplaced (Garden stages 1 and 2) fractures and 23% and 38% among those with displaced (Garden stages 3 and 4) fractures. Nonunion and avascular necrosis led to the necessity for additional surgery in 11 of 30 (36%) hips. Internal fixation of femoral neck fractures is associated with a high initial complication rate, but if successful, the procedure ensures an excellent long-term outcome. Internal fixation should be considered the treatment of choice in young patients with nondisplaced fractures.
authors.affiliation: Baskent University, Department of Orthopaedics and Traumatology, Ankara, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Karaeminogullari
authors.forename: Huseyin
authors.initials: H
authors.lastname: Demirors
authors.forename: Mesut
authors.initials: M
authors.lastname: Atabek
authors.forename: Cengiz
authors.initials: C
authors.lastname: Tuncay
authors.forename: Reha
authors.initials: R
authors.lastname: Tandogan
authors.forename: Metin
authors.initials: M
authors.lastname: Ozalay
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000601:surgery*; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000209:etiology*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D005599:Fractures, Ununited / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013997:Time Factors