Shortening And Varus Collapse Of Femoral Neck Fractures In Young Patients (<55 Years): Percutaneous Cannulated Screws Vs. Dynamic Hip Screw

Background: The treatment of femoral neck fractures in younger patients is controversial. The objective of this study is to compare varus collapse and shortening of the femoral neck in young patients ( 5 mm), and the degree of varus collapse into two groups: moderate ( 7°) with relation to the unfractured hip. Euroquol-5D (EQ5D) questionnaires were employed to evaluate clinical results. Results: Mean age was 44.1 years (range, 22-55) and mean follow-up 3.2 years (range, 2-5). Thirty-seven fractures were treated with three PCS and twenty nine with ORIF using a DHS. There were 34 undisplaced fractures and 32 displaced fractures. 21 fractures showed comminution of the medial cortex and 14 of the posterior cortex. The rate of avascular necrosis (AVN) was 9.1% (6 cases). There were no cases of nonunion. Mean femoral neck shortening was 6.2 mm (range, 1-13) and mean varus collapse was 8.1° (range, 1-15°). Patients following AVN or with severe shortening and varus collapse presented lower quality of life scores. Conclusion: We found a higher degree of varus collapse and shortening in patients treated with PCS.