Healing of femoral neck fractures; influence of fracture reduction and age.

In the present study, the influence on healing of femoral neck fractures of reduction of the fracture and the age of the patients were investigated in 446 consecutive cases treated by internal fixation. If the fracture was reduced in valgus position anteroposteriorly, 90% of the cases healed, and if anatomical reduction was achieved the figure was 77%. However, if the fracture remained in varus position bone union was obtained in only 63%. After a good lateral reduction internal fixation resulted in failures in 22% of cases, if a satisfactory in 26%, but poor lateral reduction was followed by failure in 49% of cases. There was correlation to reduction position in all Garden's Stages. With regard to the healing of the fracture, reduction in lateral as well as anteroposterior views were of equal importance. The patient's age did not influence the failure rate in 22% of cases. With increasing age progressive decrease of healing was encountered. The number of patients attending for follow-up until bony union decreased also due to a high mortality rate in these patients. Internal fixation was found to be the treatment of choice in femoral neck fractures, provided that a satisfactory reduction could be obtained.