In the elderly population, hip fractures are one of the major health problems and are often associated with poor outcome. The highest rates of hip fractures are recorded in Northern Europe and the United States, while most patients suffering from hip fractures are geriatric patients. The main cause are simple falls, while in younger patients high-energy are more often causal.
Joint preserving techniques, i.e. osteosynthesis of the femoral neck using screws or a dynamic hip screw, are the method of choice in younger patients with femoral neck fractures. To address the question whether shortening is present following internal fixation, we examined patients under 65 years with femoral neck fracture treated with osteosynthesis at an invited follow-up clinical examination and radiographic studies on possible factors, e.g. age, sex, weight, fracture classification, surgery duration, time to surgery and hospitalization time, having an influence of the extent of shortening. Furthermore, we compared both used implants, namely the dynamic hip screws and cannulated screws. We collected data from patients, who underwent surgery between 2007 and 2015 at the Department of Trauma Surgery at the Medical University of Vienna.
A total of 132 patients met our inclusion criteria and were contacted. Forty patients accepted to participate at an invited follow-up. Several radiological parameters from a 6-months postoperative x-ray and the follow-up examination were collected and compared between both treatment methods.
Simple falls were the major cause of most of the patients femoral fractures. In 87.5% of examined patients femoral neck shortening was observed, while leg length discrepancy was present in 85%. Facture type according to Pauwels classification and the patients weight were significantly correlated with shortening. We did not observe a significant difference between both fixation techniques. To validate our findings and investigate long-term consequences of femoral neck shortening and leg length discrepancy in these patients long-term prospective studies are warranted.