Effect of integrity of the posterior cortex in displaced femoral neck fractures on outcome after surgical fixation in young adults

Huang, Tsan Wen; Hsu, Wei Hsiu; Peng, Kuo Ti; Lee, Ching‐Yu

doi:10.1016/j.injury.2010.10.005

Cited by 75 publications

(62 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15 This observation is consistent with our finding that displacement (and likely comminution) leads to more shortening. Similarly, Huang et al 10 detected an increased incidence of shortening $5 mm among displaced young adult femoral neck fractures with posterior cortex disruption than among nondisplaced fractures. Because the proportion of displaced femoral neck fractures in our series was similar to the pooled results of a recent meta-analysis, 12 we suspect that the incidence of fracture shortening in most young femoral neck populations is high and primarily unreported.…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures

Stockton¹,

Lefaivre²,

Deakin³

et al. 2015

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

OBJECTIVES: To describe the incidence and magnitude of femoral neck fracture shortening in patients age younger than 60 years. Secondarily, to examine predictors of fracture shortening. DESIGN: Retrospective chart review. SETTING: Level I trauma centre. PATIENTS/PARTICIPANTS: Sixty-five patients with a median age of 51 years (interquartile range: 42-56 years) were included. Seventy-one percent were male, 75% were displaced fractures, and 78% were treated with cancellous screws. INTER-VENTION: Internal fixation with multiple cancellous screws or sliding hip screw (SHS) + derotation screw. MAIN OUTCOME MEASUREMENTS: Radiographic femoral neck shortening at a minimum of 6 weeks after fixation. RESULTS: Fifty-four percent of patients had 5 mm of femoral neck shortening (22% had between 5 and <10 mm and 32% 10 mm). Initially, displaced fractures shortened more than undisplaced fractures (mean: 8.1 vs. 2.2 mm, P < 0.001), and fractures treated with SHS + derotation screw shortened more than fractures with cancellous screws alone (10.7 vs. 5.5 mm, P = 0.03). Even when adjusting for initial fracture displacement, fractures treated with SHS + derotation screw shortened an average of 2.2 mm more than fractures treated with screws alone (P = 0.03). CONCLUSIONS: The incidence of clinically significant shortening in our young femoral neck fracture population was higher than anticipated, and 32% of patients experienced severe shortening of >1 cm. Our findings highlight the need for further research to determine the impact of severe shortening on functional outcome and to determine if implant selection affects fracture shortening. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. Design: Retrospective chart review.Setting: Level I trauma centre.Patients/Participants: Sixty-five patients with a median age of 51 years (interquartile range: 42-56 years) were included. Seventyone percent were male, 75% were displaced fractures, and 78% were treated with cancellous screws.Intervention: Internal fixation with multiple cancellous screws or sliding hip screw (SHS) + derotation screw. Main Outcome Measurements: Radiographic femoral neckshortening at a minimum of 6 weeks after fixation.Results: Fifty-four percent of patients had $5 mm of femoral neck shortening (22% had between $5 and ,10 mm and 32% $10 mm). Initially, displaced fractures shortened more than undisplaced fractures (mean: 8.1 vs. 2.2 mm, P , 0.001), and fractures treated with SHS + derotation screw shortened more than fractures with cancellous screws alone (10.7 vs. 5.5 mm, P = 0.03). Even when adjusting for initial fracture displacement, fractures treated with SHS + derotation screw shortened an average of 2.2 mm more than fractures treated with screws alone (P = 0.03). Conclusions:The incidence of clinically significant shortening in our young femoral neck fracture population was higher than anticipated, and 32% of patients experienced severe shortening of .1 cm. Our findings highlight the nee...

show abstract

Section: Discussionmentioning

confidence: 86%

“…Huang et al 10 reported a 17% incidence of femoral neck shortening .5 mm in their series of 146 patients ages younger than 60 years; however, all fractures were treated with multiple cancellous screws. Pollak et al 11 noted a 4.7% incidence of malunion in their series of 86 nongeriatric patients.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures

Stockton¹,

Lefaivre²,

Deakin³

et al. 2015

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

“…9 el fracaso de la fijación interna en las fracturas mediales de cadera depende de varios factores, entre ellos, la edad del paciente, 8,10 la calidad ósea, 11 el patrón de fractura, 12 la presencia de conminución, 13 el tiempo transcurrido hasta la cirugía 4,8,14 y la calidad de la reducción. 13,15,16 Como complicaciones asociadas se han publicado reportes de seudoartrosis y necrosis avascular hasta del 33% y 16%, respectivamente.…”

Section: Discussionunclassified

Osteosíntesis con tornillos canulados en fracturas mediales de cadera. Factores pronósticos y resultados en 93 casos

Pereira¹,

Calvo²,

Lugones³

et al. 2014

Rev. Asoc. Arg. Ort. y Traumatol

View full text Add to dashboard Cite

<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span><strong>Resumen</strong><br /> Introducción: </span><span>La reducción y osteosíntesis con tornillos canulados en las fracturas mediales de cadera constituye una opción terapéutica válida. nuestro objetivo es identificar factores pronósticos y grupos de riesgo.<br /> </span></p><p><span><strong>Materiales y Método</strong>s: </span><span>Se estudiaron retrospectivamente 93 fracturas intracapsulares de cadera tratadas con fijación interna con tornillos canulados de 6,5 mm, entre junio de 1995 y marzo de 2011 (71 no desplazadas y 22 desplazadas).<br /> </span></p><p><span><strong>Resultados</strong>: E</span><span>n 82 de los 93 casos, se observó la consolidación de la fractura. Once pacientes tuvieron complicaciones (5 seudoartrosis y 6 necrosis avascular). En el grupo de fracturas no desplazadas, la consolidación fue del 95,8% y, en el grupo de las desplazadas, del 63,6%. en este último grupo, si presentaban conminución, la consolidación fue del 50% y, en el grupo sin conminución, fue del 71,4%. El índice de consolidación fue del 46,1% con reducción cerrada y del 88% con reducción abierta. </span></p><p><span><strong>Conclusión</strong>:</span><span>La reducción cerrada y la osteosíntesis con tornillos canulados en fracturas impactadas o no desplazadas del cuello del fémur, cualquiera sea la edad del paciente, resulta un método exitoso. En las fracturas desplazadas, en cambio, la consolidación sin necrosis es menos previsible, por lo que su indicación deberá ser más meditada.</span></p><p> </p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p> </p></div></div></div></div></div></div>

show abstract

“…The use of capsulotomy in the treatment of femoral neck fractures has not been definitively established. A prospective cohort study showed that with intracapsular pressure difference >30 mm between the injury hip and the uninjured hip were found to have a higher rate of AVN [9,11]. Checking intra-capsular pressure and the routine use of a capsulotomy remains controversial and varies.…”

mentioning

confidence: 99%

The perfect reduction: Approaches and techniques

Kurylo

Templeman

Mirick

2015

Injury

View full text Add to dashboard Cite

Effect of integrity of the posterior cortex in displaced femoral neck fractures on outcome after surgical fixation in young adults

Cited by 75 publications

References 22 publications

Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures

Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures

Osteosíntesis con tornillos canulados en fracturas mediales de cadera. Factores pronósticos y resultados en 93 casos

The perfect reduction: Approaches and techniques

Contact Info

Product

Resources

About