Complication Rates Relating to the Degree of Displacement of Femoral Neck Fractures: a Clinical Study of 878 Internally Fixed Intracapsular Fractures

Author(s): Christopher R Lawrence and Martyn J Parker

Abstract

We undertook this large prospective study of intracapsular fractures treated with internal fixation to evaluate whether the degree of initial fracture displacement correlated to fracture healing complications including nonunion and avascular necrosis. We classified intracapsular fractures based on anteroposterior and lateral radiographs, as undisplaced, partially displaced and fully displaced. In total 878 patients with a non-pathological intracapsular hip fracture included in this study were treated by fixation of the fracture with three cancellous screws. Overall complications of fracture healing were 23.2% for undisplaced, 31.1% for partially displaced and 45.6% for fully displaced fractures showing correlation between fracture displacement and complication rate. The difference between the three groups for the complications of non-union and total fracture healing complications was statistically significant with an increasing complication rate as the fracture became more displaced. Intracapsular hip fractures show a progressive increase in the occurrence of fracture healing complication with increasing degree of initial fracture displacement.

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