Determinants of Outcome and Complications in Femoral Neck Fractures Treated with Dynamic Hip Screw: The Role of Age, Gender, Fracture Type, and Reduction Quality.

Background: This study aimed to evaluate the complication rates in femoral neck fractures treated with dynamic hip screw (DHS), with a focus on associations with age, gender, and fracture classification. Additionally, the impact of reduction quality on clinical outcomes was assessed. Methods: A total of 172 patients aged 21-65 years were retrospectively reviewed. Fractures were classified according to the AO and Powell angle classification systems. Reduction quality was assessed using the Garden index. Complication rates were analyzed based on reduction method, age group, gender, and fracture type. Results: A total of 172 patients were included. The overall complication rate was 7.5% (n=13), with nonunion (n=7), avascular necrosis (n=4), and implant failure (n=2) being the primary complications. Although complication and nonunion rates were higher in females, the differences were not statistically significant (P > .05). Similarly, no significant differences were observed between age groups (P > .05). However, unstable fractures (AO type B3) and high-angle fractures (Powell group 3) were significantly associated with increased complication rates (P < .05). Anatomical reduction significantly reduced complication rates compared to poor reduction (P < .01). Conclusion: Fracture type and reduction quality were the most important factors influencing complications. In particular, unstable and high-angle fractures were associated with increased risk, and the quality of reduction had a direct impact on treatment success. Age and gender did not show a significant effect on complication rates. The DHS stands out as both a biomechanically and economically effective treatment choice.