Closed reduction and fixation of high-energy femoral neck fractures: Still a viable surgical treatment option

Background: Femoral neck fracture causes disability if not treated properly and high-energy fractures usually have increased complication rates. Does closed reduction and internal fixation of femoral neck high energy fractures have increased complication rates? Methods: We used closed reduction and internal fixation using 3 cannulated cancellous screws. There were 67 patients (39 male, 28 female) included in the study. Mean age was 46.5 years (18-75). All femoral neck fractures were secondary to high energy trauma. There were 12 type I, 18 type II, 32 type III, 5 type IV fractures according to Garden classification. Results: Complications were as 1 long screw penetrating through the joint, changed with a shorter one, 1 initial failure, 3 nonunion and 3 avascular necrosis, converted to hemiarthroplasty. Conclusions: Closed reduction and internal fixation is not inferior to open reduction and internal fixation with low complication rates.