title: Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures.
abstract: OBJECTIVE
  To describe the incidence and magnitude of femoral neck fracture shortening in patients age younger than 60 years. Secondarily, to examine predictors of fracture shortening.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Level I trauma centre.
  
  
  METHODS
  Sixty-five patients with a median age of 51 years (interquartile range: 42-56 years) were included. Seventy-one percent were male, 75% were displaced fractures, and 78% were treated with cancellous screws.
  
  
  METHODS
  Internal fixation with multiple cancellous screws or sliding hip screw (SHS) + derotation screw.
  
  
  METHODS
  Radiographic femoral neck shortening at a minimum of 6 weeks after fixation.
  
  
  RESULTS
  Fifty-four percent of patients had ≥5 mm of femoral neck shortening (22% had between ≥5 and <10 mm and 32% ≥10 mm). Initially, displaced fractures shortened more than undisplaced fractures (mean: 8.1 vs. 2.2 mm, P < 0.001), and fractures treated with SHS + derotation screw shortened more than fractures with cancellous screws alone (10.7 vs. 5.5 mm, P = 0.03). Even when adjusting for initial fracture displacement, fractures treated with SHS + derotation screw shortened an average of 2.2 mm more than fractures treated with screws alone (P = 0.03).
  
  
  CONCLUSIONS
  The incidence of clinically significant shortening in our young femoral neck fracture population was higher than anticipated, and 32% of patients experienced severe shortening of >1 cm. Our findings highlight the need for further research to determine the impact of severe shortening on functional outcome and to determine if implant selection affects fracture shortening.
  
  
  METHODS
  Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Division of Orthopaedic Trauma, Department of Orthopaedics, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; †Consultant Orthopaedic Trauma Surgeon, Nottingham University Hospital, Nottingham, United Kingdom; and ‡Vancouver-Fraser Medical Program, Faculty of Medicine, University of British Columbia, Vancouver British Columbia, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Stockton
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Lefaivre
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Deakin
authors.forename: Georg
authors.initials: G
authors.lastname: Osterhoff
authors.forename: Andrew
authors.initials: A
authors.lastname: Yamada
authors.forename: Henry M
authors.initials: HM
authors.lastname: Broekhuyse
authors.forename: Peter J
authors.initials: PJ
authors.lastname: OʼBrien
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Slobogean
mesh_terms: D000328:Adult; D001863:Bone Screws / Q000706:statistics & numerical data*; D001955:British Columbia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005272:Femur Neck / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome