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Femoral Neck Fractures in Adults Treated With Internal Fixation: A Prospective Multicenter Chinese Cohort

Slobogean, Gerard P. MD, MPH, FRCSC; Stockton, David J. MD; Zeng, Bingfang MD; Wang, Dong MD; Ma, Bao-tong MD; Pollak, Andrew N. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: April 2017 - Volume 25 - Issue 4 - p 297–303
doi: 10.5435/JAAOS-D-15-00661
Research Article

Introduction: Although femoral neck fractures in young patients are rare and their complications are well-documented, there is a paucity of data on patient-reported outcomes for this population. The purpose of this study was to describe the quality of life and the effect of clinical complications on the outcomes of young patients with femoral neck fractures in a Chinese cohort.

Methods: In this prospective observational cohort study, patients aged 18 to 55 years admitted to one of three participating trauma hospitals in China for treatment of a femoral neck fracture were recruited. The primary outcome was the patient’s health-related quality of life using the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey at 1 year after injury. Associations between the primary outcome and potential predictors were explored with univariate and multivariate regression analysis.

Results: One hundred seven patients (mean age, 44 years) completed 1-year follow-up. Nearly all patients were treated with closed reduction and screw fixation. Nine cases of nonunion, 7 cases of malunion, and 11 cases of osteonecrosis were identified. The mean SF-36 Physical Component Score was 48.6 ± 8.5, and the mean Mental Component Score was 51.0 ± 7.4. Fracture displacement, quality of reduction, and nonunion were associated with a poor Physical Component Score outcome.

Discussion: Our results demonstrate that the quality of life for patients after closed reduction and screw fixation of femoral neck fractures is similar to that of the general population, particularly when complications of nonunion and malunion are avoided.

Level of Evidence: Level I

From the Department of Orthopaedics, University of Maryland, Baltimore, MD (Dr. Slobogean), the Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada (Dr. Stockton), the Shanghai Sixth People’s Hospital, Shanghai, China (Dr. Zeng), the Second Affiliated Hospital to Shanxi University, Shanghai, China (Dr. Wang), the Department of Traumatic Orthopedics, Tianjin Hospital, Tianjin, China (Dr. Ma), and the R. Adams Cowley Shock Trauma Center, Baltimore (Dr. Pollak).

Dr. Slobogean or an immediate family member serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association. Dr. Pollak or an immediate family member has received royalties from Zimmer Biomet and serves as a board member, owner, officer, or committee member of the National Trauma Institute. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Stockton, Dr. Zeng, Dr. Wang, and Dr. Ma.

This study was funded by an unrestricted grant from Smith & Nephew Orthopaedics.

Received November 13, 2015

Accepted July 11, 2016

© 2017 by American Academy of Orthopaedic Surgeons
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