![]() These complications are highly symptomatic in active patients leading to salvage procedures with significant failure rates. However, the biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head (ONFH) after internal fixation of displaced femoral neck fractures. While only 3%-10% of these fractures occur in younger adults, the major differences in physiology, injury characteristics and activity level necessitate a dedicated treatment pathway. Furthermore, early weight bearing protocols post-arthroplasty minimizes complications of prolonged inactivity.įor the non-elderly patient with good bone quality, preservation of the natural hip anatomy and mechanics is a priority as their high functional demands and young age preclude their candidacy for replacement procedures. This is based on a multitude of randomized controlled trials documenting improved short and long-term hip function and lower re-operation rates with hip arthroplasty as compared to internal fixation in elderly adults. ![]() Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures. ![]() This review will focus both on the demographics and injury profile of young patients with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications.įemoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls. Furthermore, other management variables such as surgical timing, the role of capsulotomy and the choice of implant for fixation remain controversial. Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population. The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures. However, for the physiologically young patients, preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands. Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.
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