Femoral neck shortening after internal fixation of a femoral neck fracture

Stephanie M. Zielinski, Noël L. Keijsers, Stephan F.E. Praet, Martin J. Heetveld, Mohit Bhandari, Jean Pierre Wilssens, Peter Patka, Esther M.M. Van Lieshout*, the FAITH Trial Investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

59 Citations (Scopus)


This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventysix patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were collected. Femoral neck shortening, gait parameters, and maximum isometric forces of the hip muscles were measured and differences between the fractured and contralateral leg were calculated. Variables of patients with little or no shortening, moderate shortening, and severe shortening were compared using univariate and multivariate analyses. Median femoral neck shortening was 1.1 cm. Subtle changes in gait pattern, reduced gait velocity, and reduced abductor muscle strength were observed. Age, weight, and Pauwels classification were risk factors for femoral neck shortening. Femoral neck shortening decreased gait velocity and seemed to impair gait symmetry and physical functioning. In conclusion, internal fixation of femoral neck fractures results in permanent physical limitations. The relatively young and healthy patients in our study seem capable of compensating. Attention should be paid to femoral neck shortening and proper correction with a heel lift, as inadequate correction may cause physical complaints and influence outcome.

Original languageEnglish
Pages (from-to)e849-e858
Issue number7
Publication statusPublished - Jul 2013

Bibliographical note

A list of study investigators and participating centers of the FAITH Trial appears at the end of the article.


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