Management and Treatment of Femoral Neck Fractures

Femoral neck fractures represent a significant global health burden, particularly among elderly populations, owing to their high morbidity and mortality. Management strategies hinge on patient age, physiological reserve and fracture displacement. In younger patients, preservation of the native femoral head through internal fixation is favoured to minimise long-term complications such as avascular necrosis and nonunion. In contrast, older or physiologically frail patients often benefit from arthroplasty, with hemiarthroplasty and total hip arthroplasty being the principal options. Key considerations include surgical timing to reduce systemic complications, choice of implant to optimise biomechanics and minimise reoperations, and perioperative measures to prevent infection and promote rehabilitation. Recent advances in implant design, computational modelling and enhanced recovery pathways have refined decision-making and improved outcomes. Multidisciplinary collaboration, incorporating orthopaedic surgeons, anaesthetists, geriatricians and physiotherapists, underpins successful restoration of mobility and reduction of healthcare costs.

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Management and Treatment of Femoral Neck Fractures publication trend

The graph below shows the total number of articles in management and treatment of femoral neck fractures across all publications each year (not limited to Nature Index journals).

Technical terms

Femoral neck fracture: A break in the bone connecting the femoral head to the femoral shaft, occurring within the hip capsule.

Internal fixation: Surgical stabilisation of a fracture using implants such as screws, plates or nails to maintain alignment during healing.

Hemiarthroplasty: Replacement of the femoral head and neck with a prosthesis, preserving the patient’s native acetabulum.

Total hip arthroplasty: Replacement of both the femoral head and the acetabular socket with prosthetic components.

Finite element analysis: A computational modelling technique that simulates mechanical behaviour of bone and implants under physiological loads.

Antibiotic-loaded bone cement: Polymethylmethacrylate impregnated with antibiotic agents to provide local prophylaxis against infection in joint arthroplasty.

References

1. Biomechanical evaluation of two modified intramedullary fixation system for treating unstable femoral neck fractures: A finite element analysis. Frontiers in Bioengineering and Biotechnology (2023).
2. Infection after intracapsular femoral neck fracture – does antibiotic-loaded bone cement reduce infection risk after hemiarthroplasty and total hip arthroplasty?. Bone and Joint Research (2023).
3. Hemiarthroplasty Versus Total Hip Arthroplasty for Femoral Neck Fracture in Elderly Patients. Journal of Bone and Joint Surgery (2023).