Treatment of femoral neck fractures in young adults.

OBJECTIVE To analyze the long-term effects of the quadratus femoris muscle pedicle bone graft with screw fixation for the treatment of femoral neck fractures in young adults. METHODS From 2002 to 2008, 38 patients with femoral neck fractures were operated. There were 22 males and 16 females, with an average age of 40 years (ranged 25 to 60 years). Twenty-six patients injured from high velocity road traffic accident, among which 14 patients injured in automobile accident, 8 in two wheeler accident and 4 in fall from height. Twelve patients had serious associated injuries. Femoral neck fractures were classified by Garden classification: 25 patients were Graden II and 13 patients were Graden III. Thirty-six patients underwent emergency operation and 2 had delayed operation. Clinical scores were evaluated based on Sanders scores and the radiological criteria which was judged by the diminution of density in the necrotic portion of the femoral head. RESULTS All the patients were followed up for at least 2 years (ranged 2 to 5 years). There were significant differences between preoperation and postoperation in pain, function, muscle power and walk ability. All the patients with fractures were healed in an average of 5 months after operation and walked without aids and no complications occurred. CONCLUSION This technique provides a high union rate with a low complication rate. In addition, the surgical procedure is relatively simple and has a nice long-term result.