The effect of delay time to internal fixation of the femoral neck fractures on development of femoral head avascular necrosis

Background. Avascular necrosis of femoral head (AVN) is a major complication of intracapsular femoral neck fractures. Some authors believe that early internal fixation can reduce the incidence of femoral head necrosis. Objective. The aim of this study was to assess the effect of time of the trauma to surgery delay time on development of AVN in patients with femoral neck fractures. Methods. We retrospectively analyzed 72 patients aged between 20 and 60 years who presented with intracapsular femoral neck fractures and had undergone screw internal fixation between March 2011 and March 2015. Thirty two patients whose fractures were fixed within 24 hours from injury and 40 patients whose fractures were fixed after 24 hours from injury (Max 3 days), constituted our two comparison groups in this study. All of patients were fallowed up for at least 18 months after surgery. Results. Of 72 patients with intracapsular fractures who underwent screw internal fixation, 20 patients (27.8 %) developed AVN, 14 of whom were in the group whose fractures had been fixed after 24h of injury. We did not find the delay time to internal fixation to be a significant predictor of the development of AVN (p=0.126). Conclusions. Our study demonstrated that delay in internal fixation has no significant effect on development of AVN in patients with femoral neck fractures.