title: Long-Term Outcomes Following Reduction and Fixation of Displaced Subcapital Hip Fractures in the Young Elderly.
abstract: BACKGROUND
  The surgical treatment of hip fractures remains controversial especially when considering age.
  
  
  OBJECTIVE
  To investigate the long-term functional outcomes of displaced subcapital hip fractures that were reduced and surgically fixed using parallel cannulated screws in patients aged 60 years and younger.
  
  
  METHODS
  During the period 1996-2005, 27 patients under age 60 with displaced subcapital hip fractures classified as Garden III or IV were treated with fracture reduction and surgical internal fixation using cannulated screws. Patient outcomes were assessed using the Harris Hip Score (HHS) and physical examination.
  
  
  RESULTS
  During a follow-up period of 8-17 years 4 of the 27 patients (14.8%) developed non-union/femoral head avascular necrosis and had undergone hip arthroplasty. All reoperations were performed within the first year after fracture fixation, all in the 50-60 year old age group. The revision rate among patients 50-60 years old was significantly higher than that of patients 50 years and younger (40% vs. 0%, P = 0.037). Mean HHS was higher for patients not requiring revision surgery (85.4) than for patients with revision surgery (75.5), but this difference was not significant.
  
  
  CONCLUSIONS
  Internal fixation using fracture reduction and cannulated screw fixation is a successful treatment modality for displaced subcapital hip fractures in patients under 50 years old. Patients aged 50-60 may have a higher risk of avascular necrosis or non-union and require arthroplasty, often within the first year after fracture fixation. The long-term outcome following these fractures is good when excluding patients who had early complications.
authors.forename: Shachar
authors.initials: S
authors.lastname: Kenan
authors.forename: Aviram
authors.initials: A
authors.lastname: Gold
authors.forename: Moshe
authors.initials: M
authors.lastname: Salai
authors.forename: Ely
authors.initials: E
authors.lastname: Steinberg
authors.forename: Ran
authors.initials: R
authors.lastname: Ankory
authors.forename: Ofir
authors.initials: O
authors.lastname: Chechik
mesh_terms: D000328:Adult; D000367:Age Factors; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult