Complications and risk factors after internal fixation of femoral neck fractures in young and middle-aged patients.

OBJECTIVE

This study evaluated postoperative complications and risk factors in young and middle-aged adults with femoral neck fractures.

METHODS

A retrospective case-control study was conducted on 380 patients who underwent internal fixation for femoral neck fractures between September 2019 and March 2022. The study included patients aged 16 to 65 years with unilateral femoral neck fractures treated with FNS or CCS, with a minimum follow-up of 24 months. Data collected included demographic information, clinical details, radiographic assessments, and postoperative complications. Multivariate logistic regression analysis was used to identify risk factors for complications.

RESULTS

The study included 380 patients with a mean follow-up of 28.5 ± 2.2 months and a mean age of 34.79 ± 12.76 years. In the FNS group (193 patients), complications included femoral neck shortening (9.3%), femoral head necrosis (7.8%), fracture nonunion (1.6%), and internal fixation failure (0.5%). In the CCS group (187 patients), complications included femoral neck shortening (7.5%), femoral head necrosis (5.3%), fracture nonunion (5.3%), and internal fixation failure (0.5%). Multivariate analysis revealed that in both the FNS and CCS groups, significant predictors of complications included premature weight-bearing, a posterior tilt angle greater than 20°, fracture displacement, and poor reduction quality.

CONCLUSIONS

The FNS is as effective as CCS in treating femoral neck fractures, making it a viable alternative. Identified risk factors for FNS failure include premature weight-bearing, posterior tilt > 20°, fracture type, and poor reduction quality.