Campenfeldt P, et al. - This study aimed at reporting the functional outcome and health-related quality of life (HRQoL) in 20–69 years old patients with a femoral neck fracture (FNF) treated with internal fixation. Displaced femoral neck fracture healed after one operation in two-thirds of the patients. Three quarters stated good or excellent functional outcome at 24 months. However, their pre-fracture level of HRQoL was not regained.

Methods

• This multicenter study prospectively included 182 patients 20–69 years with a FNF treated with internal fixation.
• At 4, 12 and 24 months, authors performed follow up that included radiographic and clinical examination.
• They collected data regarding hip function using Harris Hip Score (HHS), HRQoL (EQ-5D and SF-36), fracture healing and re-operations.

Results

• At 24 months, 73% of the patients with displaced fractures and 85% of the patients with non-displaced fracture indicated HHS good or excellent (p = 0.15).
• Among patients with displaced fracture (n = 120), a non-union (NU) was observed in 23% and an avascular necrosis (AVN) was evident in 15% and 28% re-operation rate was there.
• In this study, among patients with non-displaced fracture (n = 50), NU was not evident, 12% had a radiographic AVN and 8% needed a re-operation.
• In patients with displaced fracture, decrease in the mean EQ-5D_index was observed from 0.81 to 0.59 at 4 months, 0.63 at 12 months and 0.65 at 24 months (p < 0.001).
• For patients with non-displaced fracture, the corresponding values were 0.88, 0.69, 0.75 and 0.74 respectively (p < 0.001).
• In patients with displaced fracture, decrease in the mean SF-total score was observed from 76 to 55 at 4 months, 63 at 12 months and 65 at 24 months (p < 0.001).
• For patients with non-displaced fracture, the corresponding values were 80, 67, 74 and 76 respectively (p < 0.001).