FACTORS PREDICTING HEALING COMPLICATIONS IN FEMORAL-NECK FRACTURES - 138 PATIENTS FOLLOWED FOR 2 YEARS

We have previously studied the radiographic outcome of femoral neck fr acture osteosynthesis with either two hook-pins or a four-flanged nail performed by a small group of surgeons with special interest in the m ethods. In 138 femoral neck fractures a backwards stepwise logistic re gression analysis was used to study the significance of preoperative f racture-related factors, intraoperative factors and the osteosynthesis . The development of non-union/redisplacement and segmental collapse o f the femoral head was influenced by fracture displacement (P 0.001) a nd method of osteosynthesis (P 0.007). The postoperative scintimetric ratio was influenced by the method of osteosynthesis (P 0.0003), fract ure displacement (P 0.004) and by the presence of a posterior fragment (P 0.03).Reduction of the fracture and positioning of the osteosynthe sis were to a large extent within the accepted limits. This may explai n why the previously well documented negative effects of malpositionin g of the osteosynthesis and inferior reduction were not demonstrated t o influence the rate of healing-complications. We conclude that neithe r patient age, sex nor preoperative fracture variables, with the excep tion of the extent of fracture displacement, can be used to predict ra diographic healing-complications in femoral neck fractures.