Exploring patient perspectives of younger adults with complications after internal fixation of femoral neck fractures: A qualitative study

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INTRODUCTION: Internal fixation is the recommended treatment for femoral neck fractures in younger adults, as it preserves the native hip joint. However, high failure rates and suboptimal outcomes following internal fixation persist. While there is substantial research on the experiences of older adults with femoral neck fractures, the perspectives of younger adults with complications following internal fixation remain largely underexplored. This study aims to examine the lived experiences of younger adults who underwent secondary surgery after internal fixation of a femoral neck fracture, with focus on the period between the initial fixation and the subsequent operation. METHODS: This qualitative, exploratory study utilizes semi-structured interviews with younger adults who underwent secondary surgery due to complications following internal fixation of a femoral neck fracture. Participants were purposively sampled from three hospitals in Denmark. Interviews were conducted 2-4 weeks post-secondary surgery, transcribed verbatim, and analyzed using Malterud's Systematic Text Condensation. RESULTS: Eight participants (median age 61, range 38-69 years) were included. Analysis identified four overarching themes: (1) physical impact, (2) psychosocial and identity disruption, (3) healthcare and information gaps, and (4) coping and future outlook. Alarmingly, more participants reported losing the will to live, even expressing suicidal thoughts during this period. CONCLUSION: This study highlights the profound physical, psychological, and social consequences of complications following femoral neck fractures in younger adults. The findings emphasize the need for clear communication and individualized, age-appropriate, and long-term rehabilitation that integrates physical and psychological support. Tailored care pathways are essential to improve recovery and quality of life.

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