Basicervical femoral neck fractures: an observational study derived from the Swedish Fracture Register

Authors

  • Jonas Sundkvist Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå https://orcid.org/0000-0003-4615-7276
  • Per Hulenvik Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg
  • Viktor Schmidt Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå https://orcid.org/0000-0002-8727-9555
  • Per Jolbäck Department of Orthopaedics, Institute of Clinical Science, The Sahlgrenska Academy, Gothenburg University, Gothenburg; Department of Research, Development, Education and Innovation, Skaraborg Hospital, Skövde https://orcid.org/0000-0001-9402-9506
  • Mikael Sundfeldt Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg
  • Per Fischer Faculty of Medicine and Health, Örebro University, Örebro; Department of Orthopedics, Karlstad Central Hospital, Karlstad, Region Värmland
  • Cecilia Rogmark Department of Orthopaedics, Lund University, Skåne University Hospital, Malmö https://orcid.org/0000-0002-6556-4320
  • Hans Juto Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå
  • Olof Wolf Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden https://orcid.org/0000-0001-6668-8715
  • Sebastian Mukka Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå https://orcid.org/0000-0002-5469-2730

DOI:

https://doi.org/10.2340/17453674.2024.40503

Keywords:

Basal femoral neck fracture, Basicervical femoral neck fracture, Hip, Trauma

Abstract

Background and purpose: Limited research has been conducted on basicervical femoral neck fractures (bFNFs). The importance of displacement in clinical outcomes remains unclear. We aimed to characterize patient demographics, degree of displacement, treatment, treatment failures, and reoperations in a cohort of fractures from the Swedish Fracture Register (SFR).
Methods: 1,260 fractures in 1,185 individuals ≥ 60 years who had a bFNF registered in the SFR at 6 orthopedic departments from 2011 to 2020 were screened through radiographic review. The final sample included 291 patients with a confirmed bFNF. The medical records of these 291 patients were reviewed. We assessed baseline characteristics, initial fracture dislocation, treatment methods, tip–apex distance, failures, reoperations, and mortality.
Results: The mean age was 82 years (range 60–101, 55% women). 98 (34%) were undisplaced and 193 (66%) displaced. All patients underwent operative treatment. In the undisplaced group 95 (97%) patients received internal fixation (IF) and 3 (3%) had primary hip arthroplasty. In the displaced group 149 (77%) received IF and 41 (21%) had primary hip arthroplasty. 33 (11%) suffered treatment failure. When treating an undisplaced bFNF with IF, only 3 (3%) experienced treatment failure, in contrast to the 24 (16%) failure rate for a displaced bFNF.
Conclusion: Undisplaced bFNFs have a low failure rate when treated with IF. For displaced bFNF treated with IF the failure rate is considerably higher. There is a need for further investigation of classification, treatment, and outcome of bFNF.

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Published

2024-05-22

How to Cite

Sundkvist, J., Hulenvik, P., Schmidt, V., Jolbäck, P., Sundfeldt, M., Fischer, P., … Mukka, S. (2024). Basicervical femoral neck fractures: an observational study derived from the Swedish Fracture Register. Acta Orthopaedica, 95, 250–255. https://doi.org/10.2340/17453674.2024.40503