![]() ![]() Reoperation and salvage procedures such as osteotomy have high failure rates and arthroplasty procedures are not ideal given the young age and higher levels of activity. 3, 4, 8, 9 – 16 This devastating complication may lead to collapse of the femoral head and subsequent osteoarthritis. 4, 6, 9, 14 The rate of osteonecrosis reported in the literature ranges from 12-86% in young patients after femoral neck fracture. Characteristic differences are seen with respect to the osseous and vascular anatomy, the mechanism of injury, associated injuries, fracture pattern and the goals of treatment.įemoral neck fractures in young adults are associated with higher incidences of femoral head osteonecrosis 4, 6 – 13 and nonunion. 2, 5 To evaluate and treat femoral neck fractures in young adults, it is important to understand and contrast the differences between elderly and young adult patients. 2 – 4 They account for only 2-3% of all femoral neck fractures. 1 However, femoral neck fractures in adults younger than age 50 years are uncommon and often the result of high-energy trauma. Intracapsular femoral neck fractures are commonly seen in the elderly population after a trivial fall. The key factors in treating femoral neck fractures should include early diagnosis, early surgery, anatomic reduction, capsular decompression and stable internal fixation. Until there is conclusive data available, we recommend that surgery should be done on an urgent basis. ![]() The data available is inconclusive on whether this fracture should be operated emergently, urgently or can wait until the next day. prospective and controlled) we recommend performing a capsulotomy. Capsulotomy in femoral neck fractures remains a controversial issue and the practice varies by trauma program, region and country. Definitive fixation can be accomplished with three cannulated or noncannulated cancellous screws. Open reduction and internal fixation through a Watson-Jones exposure is the recommended approach. While achieving an anatomic reduction and stable internal fixation are imperative, other treatment variables, such as time to surgery, the role of capsulotomy and the fixation methods remain debatable. Multiple factors can play a significant role in preventing these devastating complications and contribute to a good outcome. They are associated with higher incidences of femoral head osteonecrosis and nonunion. Femoral neck fractures in young adults are uncommon and often the result of high-energy trauma. ![]()
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