This study indicates that the incidence of non-union in displaced intracapsular femoral-neck fractures can be decreased by: (1) accurate reduction; (2) accurately placed, adequate internal fixation; and (3) carefully supervised postoperative care.
Inadequate reduction, technical errors in fixation, and premature weight-bearing appear to be the main factors leading to non-union. Aseptic necrosis occurred in one-third of displaced fractures with more than a two-year follow-up and is the most serious remaining factor affecting the result. Whether this complication will develop in a fracture seems to be defined at the time of injury.
Despite these conclusions it must be admitted that there are some patients who have satisfactory results even though their fractures are inadequately reduced (seven of the healed group) or poorly fixed (twelve of the healed group). These results are difficult to explain.