{
  "abstract": "Objectives: We sought to characterize long-term outcomes following internal fixation of femoral neck fractures (FNFs) in a consecutive cohort and to examine factors related to treatment failure. Methods: The study comprised 427 consecutive patients treated with internal fixation for FNFs at Beijing Jishuitan Hospital during 2017. Long-term outcomes were assessed through medical-record review, available routine imaging, and telephone follow-up during the fifth postoperative year. The primary long-term outcomes were osteonecrosis of the femoral head (ONFH) and major reoperation. Risk factor analysis was performed in 234 patients with radiographic follow-up of ≥6 months, in whom treatment failure was defined as a composite of ONFH, major reoperation, malunion, nonunion, and/or fixation failure. Associations between candidate factors and treatment failure were examined using univariable and multivariable logistic regression. Results: Long-term outcome status was successfully ascertained in 373 of 427 patients (87.4%), corresponding to a loss-to-follow-up rate of 12.6%. Overall, 98 patients (26.3%) developed ONFH and 57 (15.3%) underwent major reoperation, all of which were hip arthroplasties. Among the 234 patients with radiographic follow-up, 111 (47.4%) experienced treatment failure. In the multivariable analysis, high-energy injury (adjusted odds ratio [aOR] 2.90, 95% CI 1.06–7.92), displaced fracture (aOR 12.03, 95% CI 4.33–33.40), subcapital fracture location (aOR 2.14, 95% CI 1.04–4.41), and fair-to-poor reduction quality (aOR 3.95, 95% CI 1.88–8.31) were independently associated with treatment failure. In exploratory age-stratified analyses, fracture displacement and fair-to-poor reduction quality remained consistently associated with treatment failure in both age groups. Conclusions: This consecutive real-world cohort achieved long-term outcome ascertainment in 87.4% of the original population. Long-term complications after internal fixation of FNFs remained substantial. Fracture displacement and fair-to-poor reduction quality were the most consistent factors associated with treatment failure across the primary and exploratory age-stratified analyses, emphasizing the importance of careful treatment selection and adequate fracture reduction.",
  "abstract_shown": true,
  "affiliations": [
    "Peking University Fourth School of Clinical Medicine, Beijing 100083, China",
    "Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shuo Chen",
      "orcid": "0009-0000-4103-8783"
    },
    {
      "affs": [
        1
      ],
      "name": "Shangwei Ji"
    },
    {
      "affs": [
        1
      ],
      "name": "Haohao Xu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Renwei Cao"
    },
    {
      "affs": [
        1
      ],
      "name": "Yujiang Mao"
    },
    {
      "affs": [
        1
      ],
      "name": "Yejun Zha"
    },
    {
      "affs": [
        1
      ],
      "name": "Maoqi Gong"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xieyuan Jiang",
      "orcid": "0000-0002-2993-1357"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7nzqde19zrpxa.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218656",
  "fulltext_url": null,
  "id": "7nzqde19zrpxa",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8656",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/7nzqde19zrpxa.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T00:21:23Z",
      "native_id": "10.3390/jcm15218656",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8656"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Long-Term Outcomes and Risk Factors for Treatment Failure After Internal Fixation of Femoral Neck Fractures: A 5-Year Follow-Up Study",
  "title_text": "Long-Term Outcomes and Risk Factors for Treatment Failure After Internal Fixation of Femoral Neck Fractures: A 5-Year Follow-Up Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T00:23:02Z",
  "url": "https://research.draconitic.com/paper/7nzqde19zrpxa",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}