Treatment of Neglected Femoral Neck Fractures in Young Adults

Sixteen young adults with neglected femoral neck fractures were treated from 1974 to 1981. The ages ranged from 16 to 43 years. The periods of delay after fracture were three months to two years. Most of the patients were initially treated by a "Chinese bone setter" with subsequent development of leg shortening, upward displacement of the distal fragment, and a variable degree of absorption of the femoral neck or head. Treatment included skeletal traction followed by open or closed reduction, internal fixation, or angulation osteotomy with or without bone graft. Two to eight years later, there were no cases of nonunion. Four hips developed avascular necrosis with one requiring still further surgical treatment. Thirteen patients (81%) had good to excellent results. Preservation of the patients' own hip joints was worthwhile. A defeatist attitude toward the "unsolved" fracture should be qualified.