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Complications

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  • avascular necrosis - develops in 30% of displaced and in 10% of undisplaced fractures. Treatment is total hip replacement irrespective of union as such patients will experience continued pain and progressive loss of function

  • non-union - develops in one-third of all femoral neck fractures, but especially, in displaced ones. Corrective treatment depends on the patient's age and the type of treatment already received:

  • younger patients may be considered for subtrochanteric osteotomy - if the head is alive; for a second internal fixation if there is no evidence of necrosis and reduction had originally been faulty; or for a prosthesis if necrosis has developed

  • older patients should be managed conservatively - by wearing a raised heel and walking with a stick, if the pain is mild; or with total hip replacement if the pain is intolerable and the patient is fit for operation

  • osteoarthritis - this may occur many years afterward. Total hip replacement should be considered depending on the patients age, discomfort etc.

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