Fractures of the neck of the femur in younger patients (15-50 years old). Outcome 4 years after surgery

• Published in: Zeitschrift fur Orthopadie und Unfallchirurgie Vol. 152; no. 1; p. 20
• Main Authors: Sachse, D, Beiter, C, Bludau, F, Obertacke, U, Schreiner, U
• Format: Journal Article
• Language: German
• Published: Germany 01.02.2014
• Subjects: Adolescent; Adult; Female; Femoral Neck Fractures - diagnosis; Femoral Neck Fractures - surgery; Fracture Fixation, Internal - methods; Fracture Healing; Humans; Longitudinal Studies; Male; Retrospective Studies; Treatment Outcome; Waiting Lists; Young Adult
• ISSN: 1864-6743
• DOI: 10.1055/s-0033-1360243

Traumatic fractures of the neck of the femur are rare injuries in younger patients between 15 and 50 years old. The short-term and long-term complications may cause substantial problems, in particular non-union and avascular necrosis (AVN) of the head of the femur. In the literature (and from some experts) the impression is occasionally given that there might be "proven" successful therapeutic procedures. For this purpose we retrospectively analysed follow-up-data from our own patients in the years 2003-2007 and compared them with the literature. We identified 23 of a total of 376 patients with a femoral neck fracture as a cohort being younger than 50 years. 17 of those 23 patients were treated with an internal fixation. We were able to collect and analyse complete clinical and radiological data of 11 of these 17 patients 4.2 years after surgery. The mean interval between accident and surgery was 22 hours. Only one of the patients developed an AVN after internal fixation of the fracture and was implanted a total hip replacement 18 months postoperatively. There was no non-union of the femoral neck The clinical outcome after 4.2 years was very good. The mean Harris Hip Score was 95 points (of a max. of 100 pts.). The osteosynthesis of femoral neck fractures in younger patients showed good results and a low risk of AVN and non-union. Therefore the internal fixation of the femoral neck fracture should be preferred for the younger patients instead of a primary total hip replacement.