To identify risk factors for fixation failure, avascular necrosis (AVN), and nonunion after reduction and internal fixation of femoral neck fractures in adults.
Key Findings:
Fixation failure occurred in 24.0% (n = 52) of patients.
AVN occurred in 14.3% (n = 31) of patients.
Nonunion occurred in 9.7% (n = 21) of patients.
Fixation failure was associated with displaced fracture patterns (Garden III/IV), poor reduction quality, and excessive alcohol consumption.
AVN was linked to excessive alcohol consumption, Garden III/IV fractures, and poor reduction quality.
Cannulated screw fixation and earlier surgery were associated with lower odds of nonunion.
Interpretation:
Fracture displacement, poor reduction quality, and excessive alcohol consumption are significant risk factors for fixation failure and AVN in adult femoral neck fractures. Early surgical intervention and the use of cannulated screws can reduce the risk of nonunion.
Limitations:
Single-center study may limit generalizability.
Residual confounding cannot be excluded.
Conclusion:
Optimizing reduction quality and addressing modifiable risk factors are crucial for improving outcomes in adult femoral neck fractures treated with internal fixation.
