To report upon factors predicting complication after multiple pinning of femoral neck fractures, the authors performed a comparative study upon a success group and a failure group and reviewed the literature.

Among cases of multiple pinning from July 1990 to June 1998, we defined 63 cases as successful that had more than 2 years follow-up and had no complications, and 18 cases as unsuccessful that had complications like avascular necrosis, nonunion and required a secondary operation. We analyzed the two groups from the viewpoints of age, cause of injury, classification of fracture, degree of displacement, degree of osteoporosis, time interval to operation and accuracy of reduction.

Statistically significant factors were the degree of displacement by Garden classification (p=0.007), the degree of displacement and anatomical position by AO classification (p=0.005), the time interval to operation after 7 days (p=0.012) and the postoperative accuracy of reduction (p=0.010). However, age, Singh index and the type of internal fixation device did not show statistical significance.

Displaced subcapital fracture, time interval to operation after 7 days and reduction accuracy may be prediction of complications.