Outcomes for Younger Patients with Femoral Neck Fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Rehabilitation medicine

Background:

• Limited long-term outcome data exists for young adults with intracapsular hip fractures.
• Intracapsular hip fractures are less common in young adults but can have significant functional consequences.

Purpose of the Study:

• To evaluate long-term outcomes after surgical fixation of intracapsular hip fractures in patients aged 60 years or younger.
• To identify factors associated with fixation failure and assess patient-reported outcome measures (PROMs).

Main Methods:

• Retrospective review of 112 patients (≤60 years) who underwent hip fracture fixation between 2008 and 2018.
• Failure defined as loss of fixation, nonunion, or osteonecrosis. PROMs included Oxford Hip Score (OHS), Forgotten Joint Score (FJS), EQ-5D, and UCLA Activity Scale.
• Long-term functional outcomes assessed at a mean of 7 years post-surgery.

Main Results:

• A 23% failure rate (loss of fixation, nonunion, osteonecrosis) was observed.
• 35% of patients required secondary surgery, most commonly for hardware removal or total hip arthroplasty.
• Patients experiencing failure had significantly lower OHS, EQ-5D index, EQ-VAS, and UCLA scores compared to those with primary union.

Conclusions:

• Approximately one in four young adult patients experience fixation failure after intracapsular hip fracture surgery.
• Fixation failure is linked to diminished long-term functional outcomes and health-related quality of life in this patient population.