Femoral neck fractures are associated with a high rate of nonunion. In this study, The risk factors that influence the progression to pseudoarthrosis are evaluated. in patients treated with parallel cannulated screws positioned in a triangular configuration (one proximal + two distal) or inverted triangle (two proximal + one distal) are evaluated.

Of a total of 202 patients treated between January 2000 and July 2009, 44 patients progressed to pseudoarthrosis (22%). There was no difference with respect to age, fracture location, fracture angle, and bone density. Whether there was a difference in fracture type, fixation configuration, reduction quality, and screw tip.

In conclusion, triangular configuration, displaced fractures, and inadequate reduction are risk factors for nonunion in intracapsular femoral neck fractures treated with multiple screws.

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Jui-Jung Yang et al, January 2, 2013, The Journal of Bone & Joint Surgery 95 (1): 61.