Early prediction of outcomes in hip fractures

Baysal, Özgür; Ecevız, Engin; Bulut, Güven; Bekler, Halil

doi:10.1097/bpb.0000000000000263

Cited by 7 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The vascular damage to the supply of the femoral head is considered to take place during initial injury and fracture fragment displacement and is supported by few studies [ 12 , 22 ]. Associated injuries give us an indirect way to know the severity of initial trauma and thus may help in prognostication.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Avascular Necrosis of the Femoral Head in Pediatric Femoral Neck Fractures

Chaudhary¹,

Garg²,

Mishra³

et al. 2021

Cureus

View full text Add to dashboard Cite

IntroductionA neck of femur fracture is a rare injury in the pediatric population and is of foremost importance, as it is associated with a high rate of complications. It usually occurs due to high-velocity trauma or a fall from a height. There is a scarcity of data on risk factors and their role in the prognostication of avascular necrosis. The purpose of the study was to retrospectively analyze the association of various risk factors with avascular necrosis (AVN) of the femoral head in patients with a neck of femur fracture in the pediatric age group. Material and methodsThe study included 21 (13 males and 8 females) pediatric patients with a neck of femur fracture treated at a university-level hospital. The patients were followed for a minimum of one year and the clinico-radiological outcome was analyzed using Ratliff criteria. The association of AVN with age, gender, side, fracture type, and injury with treatment delay, type of reduction, and type of internal fixation used was studied. ResultsThe mean age of the treated patients was 11 (±3.178) years (range=5-16 years). Avascular necrosis was seen in four patients and coxa vara occurred in two of them. A statistically significant association was seen between the Delbet fracture type and avascular necrosis, and three out of four cases of AVN were a Type I fracture (p-value=0.006). Three out of six patients having concomitant skeletal or other organ injuries developed AVN (p-value=0.022). The rate of AVN was higher in patients who were managed after 48 hours of initial injury but no statistically significant correlation was found (p-value=0.314). No statistically significant association with AVN was found between gender, age, type of reduction (closed/open), or the implant used (cannulated screws/k-wires). ConclusionsMultiple independent factors may have a role in the development of AVN of the femoral head in children. Prognostication should not be based on a single factor. Statistically significant results in this study have shown that the type of fracture and concomitant skeletal or other organ injuries are important risk factors and should be kept in mind. All independent risk factors must be noted and should be considered while prognosticating the outcome of a child with a neck of femur fracture.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Avascular Necrosis of the Femoral Head in Pediatric Femoral Neck Fractures

Chaudhary¹,

Garg²,

Mishra³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…There were nine studies ( 9 – 11 , 13 , 14 , 16 – 19 ); Patients' ages, as well as a mean and standard deviation, were recorded in the raw data by the study data. Utilising a weighted mean difference (WMD), a meta-analysis was conducted, and it presented no proof of study heterogeneity ( I 2 = 0%, P = 0.89).…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…The data on fracture Delbet typing was available in 12 studies ( 9 – 11 , 13 , 14 , 16 – 22 ) and was analysed through Meta-analysis. Two studies ( 13 , 22 ) did not report any cases of type I fractures, and six studies ( 9 – 11 , 17 , 19 , 20 ) did not report any cases of type IV fractures.…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…The data on initial fracture displacement from 10 studies ( 9 – 11 , 14 , 16 – 19 , 21 , 23 ) was analysed. The results indicate a mild heterogeneity between the studies ( I 2 = 20.64%, P = 0.25) was applied, as seen in Figure 4 .…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…“ Reduction methods” in medical literature refers to the two procedures of closed or opened reduction of fractures; data on the reduction methods from nine studies ( 10 – 13 , 16 – 18 , 20 , 22 ) were available for Meta-analysis. Considering that the studies had a small amount of heterogeneity ( I 2 = 36.90%, P = 0.12), see Figure 6 .…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors related with avascular necrosis after internal fixation of femoral neck fractures in children: a systematic review and meta-analysis

Wang

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundLess than 1% of children develop femoral neck fractures (FNF), making them uncommon. However, they may have dangerous side effects, like avascular necrosis. Even though several risk factors for postoperative avascular necrosis have been identified, there is still debate regarding them. In this investigation, a meta-analysis was performed to examine the potential causes of postoperative avascular necrosis in children with FNF.MethodsWe conducted a thorough literature search to find risk factors for avascular necrosis (AVN) after internal fixation of pediatric FNF. Until December 2022, we searched several databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Orthosearch, and Sinomed. Software Zotero 6.0 and Stata 17.0 were used to organise and synthesise the data. Finally, a sensitivity and publication bias test was carried out.ResultsOur study includes a total of 15 case-control studies involving 814 patients. The risk of postoperative AVN increased with age at fracture encounter (95% CI: 0.64–1.88, P = 0.0003), initial fracture displacement (95% CI: 1.87–9.54, P = 0.0005), and poor fracture reduction (95% CI:1.95–22.34, P = 0.0024) were risk factors for postoperative AVN. There was no significant relationship between gender and postoperative AVN (95% CI: 0.52–1.31, P = 0.41). Conversely, Postoperative AVN and reduction methods have no connection with each other (95% CI: 0.77–2.66, P = 0.25), procedure time (95% CI: 0.43–2.99, P = 0.16), or injury mechanism (95% CI: 0.32–2.26, P = 0.75). The incidence of post-operative AVN varies between Delbet fracture types (95% CI: 0.15–0.31, P < 0.0001), with the overall trend being that the incidence of post-operative AVN is highest for type II, lowest for type IV, and close for types I and III, but it is not clear which type of fracture is the independent risk factor. Funnel plots indicate no significant publication bias.ConclusionsIn line with this study, About 26% of children who underwent surgery for a femoral neck fracture suffered postoperative AVN. The main risk factors for AVN were the child's age, the initial displacement of the fractures, and poorly reduced fractures. The risk of AVN did not significantly correlate with gender, the time of the procedure, reduction methods or the mechanism of injury. The overall trend in the incidence of postoperative AVN for the different Delbet types of fracture is that the incidence of postoperative AVN is highest for type II, lowest for type IV, and close for types I and III, but it is not clear which type of fracture is the independent risk factor.

show abstract