Comparison of the Role of Early Versus Delayed Fixation of Intracapsular Femoral Neck Fracture in Young Population in Terms of Avascular Necrosis of the Femoral Head

Abstract

Objective: To compare the role of early versus delayed fixation of intracapsular fracture of the femoral neck in young population in terms of Avascular Necrosis (AVN) of Femoral Head. 
 Material and Methods: This quasi-experimental study was conducted in Peshawar from January 2020 till June 2021 at the Department of Orthopedic Khyber Teaching Hospital and all patients with age 18 to 60 years who had the neck of femur fracture (Garden type 1 and 2 undisplaced and Garden type 3 and 4 displaced fracture) were included who presented within one week of fracture. Group 1 consisted of the early fixation group (fixated within 24 hours) while late group 2 consisted of the late fixation group (those who fixated after 24 hours). The development of AVN was assessed on follow-up X-ray at 6 weeks, 3 months, and 6 months. Data were analyzed using SPSS. Mean and standard deviation was used for quantitative data. Frequency and percentages were used for qualitative data. A p-value of ? 0.05 was taken as significant. Shapiro Wilk’s test was done to find the normality of the data.
 Results: The mean age of the 64 included patients was 52 ± 5 years. The male to female ratio was 1:1.5. The ratio of displaced to undisplaced fracture was 2:1. A total of 34 patients belonged to group 2 while 30 to group 1. In group 2, 9 patients with displaced fracture and 2 with undisplaced fracture experienced osteonecrosis of the femoral head. While in group 1, 8 patients with displaced fracture and 1 with undisplaced fracture experienced osteonecrosis of the femoral head. No significant effect of time delay on the chances of developing osteonecrosis of the femoral head was noted in group 2 even after a delay of 24 hours with a p-value of 0.201.
 Conclusion: We conclude that there is no significant difference in the outcome of femoral neck fracture whether it was fixed early or late.