gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Results and functional outcome of femoral neck fractures in young adults

Meeting Abstract

  • C. Jones - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • D. Sietsema - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • J. Ringler - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • T. Endres - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • M. Coulibaly - Michigan State University, College of Human Medicine, Department of Surgery, Orthopaedic Research Fellowship, GRMERC, Grand Rapids, Michigan, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN19-481

DOI: 10.3205/10dkou113, URN: urn:nbn:de:0183-10dkou1132

Published: October 21, 2010

© 2010 Jones et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The purpose of this study was to evaluate long-term functional outcome, results and complications after operative treatment of femoral neck fracture (FNF) in young adults.

Methods: Over a five-year period, 2002–2007, 87 skeletally mature patients were retrospectively identified with a FNF at a Level I teaching trauma center. Outcomes were results and complications and prospective assessment of long-term functional status (Short Musculoskeletal Form Assessment [SMFA] and Short Form 36 [SF-36]).

Results and Conclusions: There were 44/87 (50.6%) males and 43 females with a mean age of 44.1 (19–65) and BMI of 26.2 (18–41). 24/87 (27.6%) were obese (BMI>30). 38/87 (43.7%) right and 49 left hips were injured and 15 had an associated ipsilateral shaft fracture. Mechanism of injury was low-energy falls (55/87, 63.2%) and high-energy injuries (32/87, 36.8%). AO/OTA fracture classification included 14 B1, 35 B2, and 38/87 (43.7%) B3 fracture pattern. Treatment consisted of 47/87 (54%) CRIF, 26 ORIF, and 14 hip arthroplasties. Reduction was anatomic in 16/73 (21.9%) of internally fixed FNF. Complications included leg length shortening (33/82, 40.2%), hardware problems (30/87, 34.5%), non-union (26/73, 35.6%), heterotopic ossification (13 Brooker I, 5 Brooker II), AVN (13/73, 17.8%), and infections (2/87, 2.2%). Table 1 [Tab. 1] summarizes functional status indices in comparison to normative. FNF without complications returned to near normal functional status (Daily 19.8, Emotion 28.3, Mobility 22.0, Dysfunction 16.1, Bother 19.2, physical 41.3, mental 53.6) and FNF with major complications had functional status (Daily 36.5, Emotion 38.6, Mobility 40.5, Dysfunction 33.0, Bother 33.1, physical 32.2, mental 51.3), which was significantly inferior compared to normative (1-way-ANOVA, p<0.001).

Obesity (BMI>30) was related to inferior functional status (p<0.05). OTA classification was related to the development of NU (ρ=0.381, p=0.001) but not functional status. Smoking status, comorbidities, and associated injuries (i.e. femoral shaft fractures) did not associate with complications or functional status.

Femoral neck fractures in younger adults are debilitating injuries. If free of complications long-term functional status returned comparatively to normative controls. However, complications led to significant impairment represented by decreased functional status scores. Increased BMI contributed to an inferior functional outcome.