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This systematic review and meta-analysis aimed to evaluate the posterior tilt angle (PTA) in predicting treatment failure after internal fixation of nondisplaced femoral neck fractures as graded by the Garden classification, which is based solely on anterior-posterior radiographic evaluation.A search was conducted of all published literature in the following databases from inception to December 20, 2021: PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov.We included English-language randomized controlled trials, prospective and retrospective cohort studies that reported malunion/nonunion, avascular necrosis, fixation failure, or reoperations in patients with nondisplaced femoral neck fractures treated with internal fixation who were evaluated for PTA using either lateral radiograph or computed tomography (CT).All abstract, screening, and quality appraisal was conducted independently by two authors. Data from included studies was extracted manually and summarized. The Methodological Index for Non-Randomized Studies criteria was used for quality appraisal.Odds ratios (OR) with 95% confidence intervals (CI) were calculated for treatment failure, defined as nonunion/malunion, AVN, fixation failure, or reoperation, in cases involving preoperative PTA ≥20 degrees and20 degrees. Statistical significance was set at p0.05.Nondisplaced femoral fractures with PTA20 degrees had a 24% rate of treatment failure compared to 12% for those20 degrees (OR, 3.21 [95% CI, 1.95-5.28]; p0.001).PTA is a predictor of treatment failure in nondisplaced femoral neck fractures treated with internal fixation. Nondisplaced femoral neck fractures with a PTA20 degrees may warrant alternative treatment modalities.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

OBJECTIVE Paradoxically, overweight and obesity are associated with lower odds of complications and death after hip fracture surgery. Our objective was to determine whether this "obesity paradox" extends to patients with "superobesity." In this study, we compared rates of complications and death among superobese patients with those of patients in other body mass index (BMI) categories. METHODS Using the National Surgical Quality Improvement Program database, we identified >100,000 hip fracture surgeries performed from 2012 to 2018. Patients were categorized as underweight (BMI