Abstract
Young patients with femoral neck fractures undergo operative stabilization urgently to prevent complications of avascular necrosis (AVN) and nonunion. The necessity of capsulotomy to prevent these sequelae is disputed. A retrospective chart review performed on 113 patients who underwent fixation of a femoral neck fracture found 62 patients following exclusion criteria, who were analyzed for demographic and fracture characteristics, operative variables, and radiographic outcomes. Sixty-two patients (age 18-85), with a mean follow-up of 21.2 months, had a mean time to union of 5.3 months. Capsulotomies were performed in 32 patients. Seven patients demonstrated AVN (5 with capsulotomy) (p = 0.285). Age was not a risk factor for nonunion or AVN. Additionally, nine fractures (four with capsulotomy) went on to nonunion (p = 0.602). We did not find increased risk of AVN in patients with diabetes or smoking, although a pre-existing diagnosis of hypertension was associated with a significantly increased risk of AVN (p = 0.04). Overall, AVN rates after operative stabilization of femoral neck fractures was 11% and not statistically influenced by capsulotomy. Hypertension was the only significant risk factor for nonunion.
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