This observational register study was designed based on data derived from the SFR. This study describes the injury mechanism, fracture classification, sex and age distribution, seasonal variation, and primary treatment in patients with fracture along the anatomical femoral neck using the Swedish Fracture Register (SFR). The incidence and treatment of bFNFs has been found to vary notably. The type of arthroplasty to be used-hemi- or total hip arthroplasty in the treatment of dFNF in elderly patients remains controversial. However, recently, hip arthroplasty has been proposed as a viable option to reduce reoperation rates and possibly improve functional outcome. The treatment of uFNFs has primarily consisted of internal fixation (IF). The treatment of FNFs in patients > 60 years is still under debate. A third, less studied category of fractures is the basicervical FNFs (bFNFs), defined as fractures through the base of the femoral neck at their junction with the intertrochanteric region. FNFs are mainly classified into undisplaced or minimally displaced (Garden 1–2, uFNF) and displaced fractures (Garden 3–4, dFNF). Level of Evidenceįemoral neck fractures (FNFs) are a subset of proximal femoral fractures commonly encountered in orthopedic practice with significant morbidity and mortality. These results may help health care providers, researchers and clinicians better understand the panorama of FNFs in Sweden. bFNF are more common than previously reported and treated with IF or arthroplasty, depending on patient age. Hip arthroplasty is the predominant treatment for dFNF. The main treatment of uFNFs is IF with screws or pins. Of the 33,105 patients with a 1-year follow-up mortality at 1-year was 20.6% for uFNF, 24.3% for dFNF, and 25.4% for bFNF. For bFNFs, IF (43.8%) and hip arthroplasty (45.9%) were performed equally often. Internal fixation (IF) (84.7%) was the main treatment for uFNFs and arthroplasty (87.3%) for dFNFs. Non-surgical treatment was performed in 0.6% (261) of the patients. The mean age of the patients in the register was 80.3 (SD 11) years and 63.8% (25,567) were female. Some 40,049 FNFs were registered in the SFR. Data on age, sex, injury mechanism, fracture classification, primary treatment, and seasonal variation were analyzed. MethodsĪll FNFs, including bFNFs with a registered injury date between 1 April 2012 and 31 December 2020, were included in this observational study from the Swedish Fracture Register (SFR). This nationwide study aims to describe the epidemiology, fracture classification, current treatment regimens, and mortality of undisplaced and minimally displaced (Garden I–II, uFNF), displaced (Garden III–IV, dFNF) and bFNFs in adults. There are few large nationwide studies, including basicervical FNFs (bFNFs), on epidemiology, treatment, and mortality. Although femoral neck fractures (FNFs) are common in orthopedic departments, optimal treatment methods remain in dispute.
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