The significance of posterior comminution in femoral neck fractures.

Major comminution of the posterior aspect of the neck in Garden Stages III and IV fractures occurs in about 70% of cases. Posterior comminution is an important cause of insecure fixation. More than half of the insecurely fixed fractures end in nonunion. Despite attempts to impart stability to the fracture by different methods of internal fixation and by a combination of posterior bone grafting and internal fixation, the rate of nonunion is still between 10% and 20%.