Age-stratified analysis of delayed fixation outcomes of femoral neck fracture among adults: A retrospective study at a tertiary care trauma center

Objective This study investigated the delayed fixation outcomes of femoral neck fractures stratified by age and surgical delay in adult patients at a tertiary care trauma center. Method A retrospective study was conducted involving patients with femoral neck fractures admitted to the orthopedic ward of the Shaheed Mohtarma Benazir Bhutto Institute of Trauma between January 2019 and March 2023. Participants aged 18–60 years who underwent delayed surgery (>48 h) were included. Data on patient demographics, fracture and surgical characteristics, and outcomes were analyzed. This study utilized chi-square or Fisher’s exact tests to compare outcomes between patients stratified by surgical delays as well as age. Results Among 108 participants, 63.9% were aged 18–30 years and 36.1% were aged 31–60 years. Avascular necrosis was predominantly observed in older patients who underwent surgery within 7 days (P = 0.001), whereas other complications such as nonunion and infection were more prevalent in patients aged 18–30 years whose surgery was delayed by >7 days (P = 0.303). Patients who underwent surgery within 7 days had shorter length of hospital stay and faster return to work in both age groups (P < 0.05), whereas those aged 18–30 years experienced the opposite when surgery was delayed beyond 7 days. Conclusions Surgical fixation within 7 days leads to better recovery and fewer complications in adults with femoral neck fractures, whereas delayed surgery provides acceptable outcomes. Age-specific protocols are key to optimizing results.