OUTCOMES OF EARLY VERSUS DELAYED SURGERY IN FEMORAL NECK FRACTURES: A RETROSPECTIVE COMPARATIVE STUDY
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Keywords
Femoral neck fracture; Surgical timing; Early surgery; Delayed surgery; Harris Hip Score; Complications; Hemiarthroplasty; Mortality; India; Uttar Pradesh
Abstract
Section Content
Background: Femoral neck fractures are a leading cause of morbidity and orthopaedic mortality among elderly adults in India, where institutional delays often push surgical intervention beyond the 48-hour recommended window. At Sharda University Hospital, Noida, resource constraints, patient optimisation requirements, and logistic bottlenecks frequently result in delayed surgical care.
Objective:To compare postoperative complication rates, functional recovery (Harris Hip Score), hospital length of stay, and time to mobilisation between patients receiving early (≤48 hours of injury) versus delayed (>48 hours) surgical fixation or arthroplasty for femoral neck fractures.
Methodology:A retrospective comparative study of 115 patients treated between October 2020 and July 2021 at SMSR, Sharda University. Patients were allocated into early (Group A, n=62) and delayed (Group B, n=53) surgery cohorts. Primary outcomes included HHS at 3, 6, and 9 months, complication incidence, and 30-day mortality. Statistical analysis was performed using SPSS v25 (Chi-square, independent t-test, Mann-Whitney U).
Results:Group A demonstrated significantly lower complication rates (DVT: 6.8% vs 14.3%; pneumonia: 5.2% vs 11.7%; p<0.05) and superior HHS at 9 months (86.2 vs 76.4; p=0.003). Mean hospital stay was shorter in Group A (7.4 vs 11.8 days, p<0.001). Thirty-day mortality was 4.6% in Group A versus 11.2% in Group B (p=0.04).
Conclusion:Early surgical intervention within 48 hours of femoral neck fracture significantly reduces postoperative complications, accelerates functional recovery, and lowers short-term mortality. Institutional protocols at Sharda University should be restructured to facilitate expedited pre-operative optimisation and theatre availability.
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Dr. Nayak Maunilkumar Rajendrakumar
Associate Professor, Department of Orthopaedics, School of Medical Sciences & Research, Sharda University, Greater Noida, Uttar Pradesh, India
Dr. Shivanand G
Associate professor, Department of Pathology, MMIMSR, Mullana,
