Complications of internally fixed femoral neck fractures.
BACKGROUND
Femoral neck fractures in young patients are the emergent injuries that require precise reduction and stable fixation. Despite all advances, nonunion and avascular necrosis (AVN) of the femoral head are the major complications necessitating salvage procedures. In this retrospective series, we evaluated the complications of internally fixed femoral neck fractures.


METHODS
This study consisted of 32 cases that had displaced femoral neck fractures. Although some of them admitted to hospital more than 8 hours after initial trauma, all underwent internal fixation as early as possible. All the fractures were reduced and fixed by closed reduction under fluoroscopy control. However, 5 cases needed open reduction. AVN was determined by using Ficat and Arlet criteria. Clinical evaluation was performed based on the scoring system described by Harris.


RESULTS
Mean follow-up period was 49+/-29 months (range 24-126). AVN of the femoral head was observed in 13 cases (40%). However, only 5 of them had unsatisfactory clinical results requiring salvage surgery as total hip replacement. Nonunion of fracture was seen in 5 cases. In the statistical analysis, a negative correlation was observed between the degree of AVN and clinical findings. We found no correlation between the duration of the preoperative period and late complications.


CONCLUSIONS
AVN is the most common complication of displaced femoral neck fractures. However, less than half of these cases require salvage procedures. Total hip replacement is the preferred treatment option for these cases.
Kayali
Cemil
C
Department of Orthopaedics and Traumatology, Tepecik Education and Research Hospital, Izmir, Turkey. cemilkayali@yahoo.com
Ağuş
Haluk
H
Arslantaş
Mustafa
M
Turgut
Ali
A
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome