New scoring system predicts osteonecrosis risk after femoral neck fixation

Researchers in a retrospective, multicenter study of 1012 patients aged 18 to 65 developed the FNF-ON8 score, an 8-point tool combining age, fracture displacement, comminution, and fracture line location to estimate risk of posttraumatic osteonecrosis of the femoral head after cannulated screw fixation. The study reported that the score showed greater discrimination than the Garden classification (AUC 0.80 versus 0.70), with osteonecrosis developing in 4% of patients scoring 0 to 3 versus 42% of those scoring 6 to 8. The authors state the score may complement existing fracture classifications for preoperative risk counseling and follow-up planning, and called for prospective external validation.

Most relevant for: Patients under 65 years undergoing internal fixation of femoral neck fractures with cannulated screws.

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