RETRACTED ARTICLE: Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis

Wang, Weiguo; Wei, Junjie; Xu, Zuojun; Zhuo, Wenkun; Zhang, Yuan; Rong, Hui; Cao, Xia; Wang, Pingshan

doi:10.1186/1471-2474-15-167

Cited by 16 publications

(9 citation statements)

References 24 publications

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“…When necessary, open reduction could be performed. 16 Wang 17 conducted a meta-analysis, pooling the results to evaluate the correlation between ONFH and various reductions, open and closed, for femoral neck fractures. The results indicated there was a significant difference in terms of ONFH between the 2 reduction types.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures

Wang

Han

et al. 2015

Medicine

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The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

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Section: Discussionmentioning

confidence: 99%

Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures

Wang

Han

et al. 2015

Medicine

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“…One study reported that for femoral neck fractures with signi cant displacement, the rate of necrosis was higher after open vs closed reduction but there was no difference in healing rate. [45] Use of stable-length implants…”

Section: Factors Contributing To Complicationsmentioning

confidence: 99%

Finite Element Analysis of Necessity of Reduction and Selection of Internal Fixation for Valgus-impacted Femoral Neck Fracture

Dai¹,

Dou³

et al. 2020

Preprint

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BackgroundAlthough valgus-impacted fractures don’t displace obviously, a larger valgus angle and posterior tilt of the femoral head can cause hip joint dysfunction and femoral head necrosis. The optimal surgical approach for valgus-impacted femoral neck fractures remains controversial. This study compared the biomechanical characteristics of different treatment strategies based on finite element analysis.MethodsTen valgus-impacted femoral neck fractures were analyzed in terms of posterior tilt and valgus angle measured on X-ray radiographs. Using these data, we generated 7 finite element models that were compared in terms of von Mises stress distribution and displacement.ResultsIn the intact femur, von Mises stress was concentrated at the medial and inferior sides of the femoral neck. In valgus-impacted femoral neck fractures, von Mises stress was at the same locations but was 5.66 times higher than that in the intact femur. When 3 cannulated screws were used for internal fixation, anatomic reduction diminished the stress at the fracture end from 140.6 to 59.14 MPa, although displacement increased from 0.228 to 0.450 mm. When the fracture was fixed with a sliding hip screw (SHS) + cannulated screw, there was less stress at the fracture end and greater displacement with anatomic reduction than that without reduction (stress: 15.9 vs 37.9 MPa; displacement: 0.329 vs 0.168 mm).ConclusionsThe SHS + cannulated screw has superior biomechanical stability than 3 cannulated screws, and is recommended following anatomic reduction to treat valgus-compacted femoral neck fractures.

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“…For example, percutaneous cannulated screw fixation and closed reduction are effective in treating adolescents with femoral neck fractures, and minimal time from trauma to operation, rigid internal fixation, and good reduction can reduce the incidence of avascular necrosis and complications. Through comparing the treatment effects of closed reduction and open reduction for femoral neck fractures, closed reduction is found to have lower complication rates (including nonunion fracture healing and avascular necrosis). However, the results of different studies are not consistent.…”

Section: Introductionmentioning

confidence: 99%

“…For femoral neck fractures, the therapeutic efficacies and postoperative complications of open reduction and internal fixation (ORIF) and closed reduction and internal fixation (CRIF) are similar and have no significant differences. A meta‐analysis by Wang et al (2014) evaluated the correlation between avascular necrosis and open/closed reduction for femoral neck fractures, revealing that CRIF leads to a higher avascular necrosis rate compared with ORIF. However, that meta‐analysis was not focused on femoral neck fractures in children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

Poor Outcomes of Children and Adolescents with Femoral Neck Fractures: A Meta‐Analysis Based on Clinical Studies

Chen

Zhang²,

Guo

et al. 2020

Orthopaedic Surgery

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Objective: To comprehensively assess the differences in outcome between open reduction and closed reduction for children and adolescents with femoral neck fractures.Methods: Based on the predetermined strategies, eligible studies were obtained by searching Embase, the Cochrane Library, and PubMed databases (retrieval time: June 2018) and through manual retrieval for paper documents. The 95% confidence intervals (CI) and risk ratios (RR) were used as evaluation indexes. Moreover, the results of avascular necrosis, coxa vara, or non-union were compared between open reduction and closed reduction under random or fixed effects models. After sensitivity analysis was carried out, publication bias was evaluated for the eligible studies using Egger's test.Results: Six studies were included in our meta-analysis. No significant heterogeneity was found among the included studies (P ≥ 0.05) and, thus, the fixed effects model was used for merging the effect sizes of avascular necrosis (RR [95% CI] = 0.50 [0.26, 0.98], P = 0.04), coxa vara (RR [95% CI] = 0.16 [0.04, 0.70], P = 0.01), and non-union (RR [95% CI] = 0.22 [0.05, 0.93], P = 0.04). Sensitivity analysis suggested that the results of avascular necrosis were not stable (RR = 0.50, 95% CI = 0.25 1.17, P = 0.12), while those of coxa vara and non-union were stable. There was no significant publication bias among the eligible studies (t = −0.70, P = 0.522).Conclusion: Femoral neck fractures treated by open reduction had less adverse outcomes compared with those treated by closed reduction.

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RETRACTED ARTICLE: Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis

Cited by 16 publications

References 24 publications

Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures

Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures

Finite Element Analysis of Necessity of Reduction and Selection of Internal Fixation for Valgus-impacted Femoral Neck Fracture

Poor Outcomes of Children and Adolescents with Femoral Neck Fractures: A Meta‐Analysis Based on Clinical Studies

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