Predictors of hip screw fixation failure following femoral neck fractures at a tertiary hospital in Tanzania

Background Femoral neck fractures have been increased in numbers past 2 decades. Its incidence is bimodal where by affect both young population (high energy trauma) and elderly population (low energy trauma). Hip screw is far more desirable fixation to young active patients, it associated with early post operative fixation failure, yet its proportional and predictors of failure have not well been known in our locality. This study aimed to determine the predictors of hip screw fixation failure among patients with femoral neck fracture. Methodology A retrospective cohort study of adults who underwent hip screw fixation for femoral neck fractures between May 2020 and May 2025. The primary outcome was hip screw fixation failure. Results A total of 59 patients with femoral neck fractures treated with hip screws were included (mean age 39.5 ± 12.7 years; 72.9% male). Fixation failure occurred in 12 patients (20%), with varus collapse being the most common mode of failure (50%), followed by screw breakage (25%). Age, Pauwels fracture classification, and quality of reduction were significantly associated with fixation failure. Conclusion Factors like sex, comorbidities, number of screws, considered during fixation however age, fracture patterns and quality of reduction becoming the crucial predictors of the successful outcome prior to fixation.