Undisplaced femoral neck fractures--no problems? A consecutive study of 224 patients treated with internal fixation

Injury. 2009 Mar;40(3):274-6. doi: 10.1016/j.injury.2008.05.023. Epub 2008 Dec 13.

Abstract

224 patients with undisplaced femoral neck fractures treated with two parallel Hansson hook pins were studied. After a mean follow-up time of 32 months (S.D. 5.2), 15% had a reoperation. 11% were considered failures, mostly avascular necrosis, and 9% had a secondary arthroplasty. Possible risk factors for poor outcome were analysed. Neither high age nor surgical delay was associated with increased failure rate. Survivors received a questionnaire, and 40% stated that they had mild or severe pain in the hip when walking, 25% had pain at rest and 25 stated that they thought "always" or "often" about their injury. The younger the patient, the more frequent the report of subjective pain. 51% of individuals under 80 years reported pain when walking, compared to 27% aged 80 or older (p=0.016). Corresponding numbers for pain at rest were 32 and 12% (p=0.034). The failure rate did not differ between the age groups, but the younger patients had more reoperations (p=0.046) and thought more frequently about their injury (p=0.016). An undisplaced femoral neck fracture is a major injury with a long-term daily discomfort in about 25% and clinical failure in 11%.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Femoral Neck Fractures / complications
  • Femoral Neck Fractures / psychology
  • Femoral Neck Fractures / surgery*
  • Fracture Fixation, Internal / methods*
  • Fracture Healing / physiology*
  • Fractures, Ununited / complications
  • Fractures, Ununited / psychology
  • Fractures, Ununited / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / psychology
  • Range of Motion, Articular / physiology
  • Reoperation / statistics & numerical data*
  • Surveys and Questionnaires