Fractures of the proximal part of the femur in patients under 50 years of age.

We present a retrospective study of the epidemiology and the results of treatment of fractures of the proximal femur in 74 patients aged 50 or under. Cervical fractures comprised 17% of the 74 fractures and were equally caused by high and low energy trauma. Trochanteric and subtrochanteric fractures comprised 83% of the total and were mainly caused by high-energy trauma. The rate of complications was 25% for the cervical fractures (two avascular necroses and one non-union) and was attributed to a valgus malalignment and to the use of bulky implants. Similarly the rate of complications was 22.5% for the trochanteric and subtrochanteric fractures (mal-union and displacement into varus) and was attributed to early collapse of the fracture and the inability of the implant to withstand the strain before osseous union. Furthermore, intramedullary fixation of subtrochanteric fractures should be preferred to the sliding screw and side plate. In conclusion, we believe that proximal femoral fractures in young patients require great attention to the correct reduction and the appropriate choice of implant, in order to minimize the chances of the development of serious complications.