title: [Failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old].
abstract: OBJECTIVE
  To investigate the failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old retrospectively inorder to pay more attention to the treatment of these fractures.
  
  
  METHODS
  From Junary 2007 to June 2010,18 failed cases of internal fixation on displaced femoral neck fractures in adults under fifty-five years old were treated,there were 13 males and 5 females with an average age of (48.0 +/- 6.0) years old ranging from 27 to 55. Among them, 17 patients were treated with cannulated screws and 1 patient was treated with intramedullary nail; 16 patients were diagnosed as osteonecrosis and 2 patients as osteonecrosis associated with nonunion.
  
  
  RESULTS
  The average time from internal fixation to failure was 23 months (ranged, 8 to 32 months). The quality of fracture reduction in Garden index was poor. The Harris Hip Score was (56.0 +/- 12.5) (ranged,33 to 80). Eight cases of osteonecrosis and 2 cases of nonunion combinated osteonecrosis were received total hip arthroplasty. Hip resurfacing arthroplasty were performed for other 5 osteonecrosis. Because of no evident clinical symptoms,the other 3 cases received conservative treatment. The patients with total hip arthroplasty and hip resurfacing arthroplasty were followed-up for 34 months ranging from 12 to 53 months. After operation,the Harris score was (94.0 +/- 3.0) ranged 89 to 96.
  
  
  CONCLUSIONS
  Osteonecrosis is a common complication after internal fixation on displaced femoral neck fracture in adults under fifty-five years old. More attention should be paid to the treatment of displaced femoral neck fracture in those patients.
authors.affiliation: Department of Orthopaedics, the 1st People's Hospital of Shanghai Jiaotong University, Shanghai 200080, China. yyx511@yahoo.com.cn
authors.forename: Yin-Xian
authors.initials: YX
authors.lastname: Yu
authors.forename: Jin-Zhong
authors.initials: JZ
authors.lastname: Ma
authors.forename: Li-Bo
authors.initials: LB
authors.lastname: Zhu
authors.forename: Hai-Ming
authors.initials: HM
authors.lastname: Lu
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Sang
mesh_terms: D000328:Adult; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure