Integrity of posterior retinaculum after displaced femoral neck fractures

Papadakis, Stamatios A.; Segos, Dimitrios; Kouvaras, Ioannis; Dagas, S.; Malakasis, M.; Grivas, Theodoros B

doi:10.1016/j.injury.2008.07.024

Cited by 18 publications

(6 citation statements)

References 10 publications

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“…3 One possible reason could be the low incidence of Garden type 1 fractures in the current study. Papadakis et al 42 showed that the posterior retinaculum was intact in almost all Garden type 3 fractures and the majority of Garden type 4 fractures, which refutes the widely held notion that blood flow is interrupted due to the anatomical disruption of the vessels in the posterior retinaculum. In the current study, no statistically significant association was found between the injury and treatment interval and AVN.…”

Section: Fracture Of the Neck Of Femur In Adultsmentioning

confidence: 94%

PET/CT Study of Temporal Variations in Blood Flow to the Femoral Head Following Low-energy Fracture of the Femoral Neck

Kumar¹,

Belehalli²,

Ramachandra³

2014

Orthopedics

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Earlier studies on femoral neck fractures have assessed the blood flow in either the pre- or postoperative period and information is lacking regarding changes in vascular flow to the femoral head after injury. Sixty-two adults with low-energy intracapsular femoral neck fractures were studied prospectively. Mean patient age was 57.2 years (range, 45-82 years). All patients underwent positron emission tomography/computed tomography (PET/CT) prior to surgical intervention and 6 weeks after internal fixation. Internal fixation was done using cannulated cancellous titanium screws and serial follow-up radiographs were obtained (at monthly intervals for the first 3 months followed by 3 monthly intervals between radiographs up to 2 years). On the preoperative PET/CT, 13 patients showed intact vascularity, 31 showed total loss of vascularity, and 18 showed partial loss of vascularity of the femoral head. The 6-week postoperative PET/CT scan showed recovery of blood supply in 23 of the 31 patients with total loss of vascularity and 15 of the 18 patients with partial loss of vascularity of the femoral head. Eleven of 62 patients had total or partial avascularity at the 6-week postoperative PET/CT scan and all 11 patients showed evidence of avascular necrosis on plain radiographs at the end of 2 years. The association between the vascular status of the femoral head at 6 weeks and avascular necrosis at the end of 2 years was statistically significant (P<.001). This study shows that the femoral head undergoes temporal variations in blood flow following femoral neck fracture. Decreased or absent vascularity is seen in approximately 75% of the fractures and 80% of the femoral heads with initial vascular compromise seem to regain blood flow within 6 weeks. Thus, prognostication about vascularity based on single-point preoperative imaging is difficult. The 6-week postoperative PET/CT scan seems to be reliable in predicting the future status of the femoral head. However, decision making regarding hemiarthroplasty or internal fixation at the time of injury may have to depend on factors other than the preoperative vascular status of the femoral head.

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Section: Fracture Of the Neck Of Femur In Adultsmentioning

confidence: 94%

PET/CT Study of Temporal Variations in Blood Flow to the Femoral Head Following Low-energy Fracture of the Femoral Neck

Kumar¹,

Belehalli²,

Ramachandra³

2014

Orthopedics

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“…The IR connected to the femur just on both ends with no connection to the bone in the middle, so the inferior retinacular artery was more mobile than the other retinacular vessels and might be more likely to escape injury after fractures, and this had been observed both in anatomy study and the clinic cases. 15 20 Although the superior and anterior retinaculum were found connecting to the bone all the path, the degree of tightness of each segment was different. The retinacula of Weitbrecht were fixed to the bone tightly at both ends but loose to the bone in the middle.…”

Section: Discussionmentioning

confidence: 99%

“…However, FHN did not occur although the femoral neck fracture was seriously displaced in some patients, 15 16 which suggests that the blood supply was not fully blocked. To find out whether there are special structures of the retinacula of Weitbrecht to protect the retinacular arteries when the femoral neck is seriously displaced, which may be the cause of these clinical observations, we observed and analyzed the micro-structure of the retinacula of Weitbrecht.…”

Section: Introductionmentioning

confidence: 94%

Histological Observation of the Retinacula of Weitbrecht and Its Clinical Significance

Dou

Mei

Wang

et al. 2018

IJOO

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“…80 However, it is interesting that some authors had observed the medial retinaculum to remain intact in a vast majority of cases despite sustaining displaced Garden III or IV type fractures. 82 This can be explained by the mobile nature of the medial retinaculum, attached to the femur only at either ends and therefore lax in between. 81 It was also found to be the strongest among the three retinacula.…”

Section: Clinical Relevancementioning

confidence: 99%

Plicae: Where Do They Come from and When Are They Relevant?

Wong

Lalam

2019

Semin Musculoskelet Radiol

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Synovial plicae are vestigial folds of synovium in a joint, most widely recognized in the knee and also in the elbow and hip joints. The most commonly shared theory on the origin of plicae is that they are the remnants of the membranes that divide the synovial cavitations during normal joint development. Synovial folds do not generally cause any symptoms. However, they can become inflamed, thickened, fibrosed, and also impinged in the joint, leading to mechanical symptoms and chondral damage. This article presents an overview of the embryological origin of plicae, their anatomy, pathologies, and appearances on imaging. We also discuss the lesser known plicae in various other areas.

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Integrity of posterior retinaculum after displaced femoral neck fractures

Cited by 18 publications

References 10 publications

PET/CT Study of Temporal Variations in Blood Flow to the Femoral Head Following Low-energy Fracture of the Femoral Neck

PET/CT Study of Temporal Variations in Blood Flow to the Femoral Head Following Low-energy Fracture of the Femoral Neck

Histological Observation of the Retinacula of Weitbrecht and Its Clinical Significance

Plicae: Where Do They Come from and When Are They Relevant?

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