Undisplaced fracture of the neck of the femur: results of treatment of 100 patients treated by single Watson-Jones nail fixation.

In a review of 100 patients with clinical and radiological evidence of undisplaced Garden stage I and II fractures of the neck of the femur treated by fixation with a single Watson-Jones nail, the early mortality was 4 per cent and in 93 cases with complete radiological data important displacement of the fracture during surgery occurred on one occasion. Of 72 patients with a mean follow-up of 22.6 months (range 3-83 months) 68 patients (94.4 per cent) achieved union and non-union occurred in 4 patients (5.6 per cent) all of whom required further surgery. In 40 patients with united fractures with a minimum follow-up of 2 years (mean 41.2 months; range 24-83 months) the overall incidence of avascular changes was 22.5 per cent; three patients required revisional surgery for late segmental collapse and a further six patients had avascular changes with minimal symptoms. Single nail fixation is a safe reliable procedure and there appears to be little indication for multiple fixation or compression devices for this fracture.