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Flexion contracture
1%
11/1442
Hip instability
Nonunion
8%
116/1442
Abductor lurch
5%
69/1442
Osteonecrosis
85%
1230/1442
Select Answer to see Preferred Response
Femoral neck fractures in young patients are difficult to treat, and AVN is a significant concern. Despite advances in both imaging and implants, this injury often leads to functional impairment. Haidukewych et al followed treatment of femoral neck fractures in young patients. They found almost 10% of displaced fractures were associated with the development of nonunion, where as 27% were associated with the development of osteonecrosis. Their results were influenced by fracture displacement and the quality of reduction. Varus malreduction most closely correlates with failure of fixation after reduction and cannulated screw fixation. Swiontkowski reviews both the treatment and post operative complications in intracapsular hip fractures. In this Current Concept Review, the rate of AVN was discussed as being related to the pre-operative degree of displacement seen on radiographs. Incorrect Responses: Answers 1 & 4: While each of these complications do occur, they are less common and are related to the approach and degree of surgical dissection. Answer 2: Hip instability is relatively uncommon. Answer 3: Nonunion rate is significant but lower than the AVN rate. It is has been associated with the degree of initial displacement and varus malreduction.
4.4
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