Evidence brief
Open Reduction and Internal Fixation Versus Total Hip Arthroplasty for Displaced Femoral Neck Fractures
Young patients (<60 years) with displaced femoral neck fractures have high complication rates after ORIF
Reoperation rates up to 40% in some series
AVN rates 10-30% depending on displacement and timing
Supports fixation in young patients despite complications due to hip preservation
Quality of reduction crucial for outcomes
In young patients with femoral neck fractures, internal fixation remains the standard despite high complication rates, as hip preservation is paramount. Quality of reduction and urgent surgery (<6 hours debated, <24 hours supported) may influence AVN rates.
Young patient with displaced NOF = ORIF to preserve native hip. Know the complication rates (nonunion 10-20%, AVN 15-30%, reoperation 30-40%). Discuss capsulotomy, anatomic reduction, and stable fixation as keys to success.
Slobogean GP et al. Complications following young femoral neck fractures. Injury. 2015;46(3):484-491.
Level III
Retrospective comparative study or case-control study