Hip Pelvis.  2016 Mar;28(1):35-42. 10.5371/hp.2016.28.1.35.

The Correlation between the Fracture Types and the Complications after Internal Fixation of the Femoral Neck Fractures

  • 1Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea. shalee@chosun.ac.kr


This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation.
The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification. The occurrence of nonunion and avascular necrosis were reviewed with clinical results including Harris hip score and Lunceford hip function test. The correlation between the fracture pattern and occurrence of complications were analyzed.
Fracture site union was achieved in 40 hips with the average union time of 17 weeks. Five nonunions occurred which showed high likelihood to occur in subcapital type, displaced (Garden stage III or IV) and Pauwels type III fractures (P<0.05). Avascular necrosis was developed in 10 hips which was mostly in subcapital type and Pauwels type III fracture but no statistical significance was found (P>0.05). The mean Harris hip score was 91 points, and Lunceford functional results were excellent in 15 hips, good in 24, fair in 4 and poor in 2.
There was high risk of nonunion in subcapital type fracture, displaced fracture (Garden stage III and IV) and vertically oriented fracture (Pauwels type III). Careful attention is needed in these fracture types.


Avascular necrosis; Femur neck fractures; Internal fixation; Nonunion

MeSH Terms

Femoral Neck Fractures*
Femur Neck*


  • Fig. 1 (A) Simple anteroposterior radiograph of pelvis shows nondisplaced femoral neck fracture. (B, C) Immediate postoperative radiographs showing internal fixation with 3 cannulated screws. (D, E) Postoperative 2 years and 8 months radiograph showing bone union without complications.

  • Fig. 2 (A) Simple anteroposterior radiograph of pelvis shows displaced basiceervical type femoral neck fracture. (B, C) Immediate postoperative radiographs showing internal fixation with compression hip screw. (D, E) Postoperative 2 years and 3 months radiograph showing bone union without complications.

  • Fig. 3 (A) Simple anteroposterior radiograph of pelvis shows displaced femoral neck fracture. (B, C) Immediate postoperative radiographs showing internal fixation with 4 cannulated screws. (D) Postoperative 3 years and 6 months radiograph showing avascular necrosis of right femoral head. (E) Secondary postoperative radiograph of pelvis showing total hip arthroplasty.


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