scholarly journals The clinical and radiographic characteristics of avascular necrosis after pediatric femoral neck fracture: a systematic review and retrospective study of 115 patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Pengfei Xin ◽  
Yonggang Tu ◽  
Zhinan Hong ◽  
Fan Yang ◽  
Fengxiang Pang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Retrospective Study ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Rapid Progression ◽  
Femoral Head Collapse ◽  
Neck Fracture ◽  
Strong Relation ◽  
The Mean

Abstract Background Avascular necrosis (AVN) after pediatric femoral neck fracture (PFNF) showed poor prognosis, but its clinical and radiographic characteristics remained unclear. Methods A systematic review and a retrospective study were performed to evaluate the clinical and radiographic characteristics of patients with AVN after PFNF. Results A total of 686 patients with PFNF and 203 patients with AVN from 21 articles were analyzed. Ratliff’s classification was used in 178 patients, with types I, II, and III AVN accounting for 58.4%, 25.3%, and 16.3%, respectively. Ratliff’s assessment was used in 147 patients, of whom 88.4% had an unsatisfactory prognosis. In retrospective study, 115 patients with a mean age of 13.6 ± 2.0 years were included. The mean interval between AVN and PFNF was 13.7 ± 9.5 months. At the time of diagnosis, 59.1% cases were symptomatic and 65.2% progressed to collapsed stage. Fifty (43.5%), 61 (53.0%), and 4 patients (3.5%) were defined as types I, II, and III , respectively, via Ratliff’s classification. Thirteen (11.3%), 40 (34.8%), and 62 patients (53.9%) showed types A/B, C1, and C2 disease, respectively, via the JIC classification. Multivariate analysis demonstrated a strong relation between collapsed stage and symptomatic cases (OR = 6.25, 95% CI = 2.39–16.36) and JIC classification (OR = 3.41, 95% CI = 1.62–7.17). Conclusion AVN after PFNF showed a tendency toward extensive necrotic lesions, presumably resulting in a rapid progression of femoral head collapse. And the symptoms and the JIC classification are other two risk factors of collapse progression.

scholarly journals Muscle pedicle bone flap transplantation for treating femoral neck fracture in adults: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yipeng Wu ◽  
Muguo Song ◽  
Guangliang Peng ◽  
Yongqing Xu ◽  
Yang Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Surgical Techniques ◽  
Femoral Neck Fractures ◽  
Bone Flap ◽  
Cochrane Library ◽  
Number Of Patients ◽  
Neck Fracture

Abstract Background This systematic review was conducted to gather available evidence on the effectiveness of muscle pedicle bone flap transplantation in adult patients with femoral neck fractures. Methods Databases such as PubMed, EMBASE, IEEE, Web of Science, and Cochrane library were searched from their dates of inception until March 2021. Two reviewers independently selected the interventional studies on the assessment of the effectiveness of muscle pedicle bone flap transplantation for femoral neck fractures; data extraction and assessment of the methodological quality as per the Institute of Health Economics quality appraisal checklist were also performed by the reviewers. The effectiveness and complication outcomes were assessed by calculating the average rates. Results Overall, 20 studies with 1022 patients were included in this review. Notably, the methodologic quality of the included studies was typically poor. The average effective rates were as follows: good, 73.4%; fair, 15.4%; and poor, 10.9%. Moreover, the average nonunion rate, average avascular necrosis rate, average collapse rate, and the overall reoperation rate were 9.0%, 6.7%, 4.7%, and 7.3%, respectively. Conclusions This systematic review of heterogeneous studies with varying number of patients and varying surgical techniques indicated that muscle pedicle bone flap transplantation provides promising results with low rates of avascular necrosis and nonunion. Nevertheless, further controlled studies are required to ascertain the effectiveness of muscle pedicle bone flap transplantation in treating femoral neck fracture.

scholarly journals The relationship between femoral neck fracture in adult and avascular necrosis and nonunion: A retrospective study

2019 ◽  
Vol 39 ◽  
pp. 5-9 ◽  
Author(s):  
Saeed Koaban ◽  
Raheef Alatassi ◽  
Salman Alharbi ◽  
Mansour Alshehri ◽  
Khalid Alghamdi
Keyword(s):  
Retrospective Study ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Neck Fracture ◽  
The Relationship

scholarly journals Outcome Analysis of Osteosynthesis Versus Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Young Elderly Patient

2021 ◽  
pp. 53-59
Author(s):  
Muhammad Rafique Joyo ◽  
Nizam Ahmed ◽  
Ghazanfar Ali Shah ◽  
Aftab Alam Khanzada ◽  
Tanveer Afzal ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Functional Performance ◽  
Clinical Status ◽  
The Elderly ◽  
Recurrent Dislocation ◽  
Outcome Analysis ◽  
Sudden Increase ◽  
Neck Fracture ◽  
The Mean

This study was designed to compare the osteosynthesis and hemiarthroplasty treatment among the elderly population and evaluate the postoperative functional performance of these two recommended treatments of a displaced femoral neck fracture. Methodology: This retrospective study was conducted in Bone Care trauma center Heerabad  Hospital Hyderabad Pakistan from March 2019 to March 2020. A total of 74 patients of age between  60 to 70 years were selected. All the selected patients were diagnosed with femoral neck fractures (Garden’s III and IV). Harris's hip score was used to evaluate the clinical status of patients with pain, whereas we used Palmer and Parker's mobility to access mobility. Implant breakage, screw cut, and nonunion were considered as parameters of osteosynthesis failure. At the same time, hemiarthroplasty failure was defined as two or more recurrent dislocation, aseptic loosening, periprosthetic fracture, and infection. Results:  In the first three postoperative months, the mean score of the hemiarthroplasty group was reported as 74.44±8.480, which was comparatively high than the osteosynthesis group (66.44±8.520). After six months, this score reached 80.12±7.005 in the hemiarthroplasty group and reached its maximum of 92.14±7.125. After the first three months, the increment ratio was relatively slow with six ratios, but in the last visit, we observed a sudden increase in score in both groups. Regarding Palmer and Parker's mobility score, the hemiarthroplasty group reflected better outcomes than the osteosynthesis group. Conclusion: Our study concluded that management of displaced femoral neck fracture with osteosynthesis revealed a high probability of nonunion, screw cutout complications and enhanced the risk of reoperation. Patients treated with osteosynthesis showed delay rehabilitation.

scholarly journals The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 16 (3) ◽  
pp. 222-232
Author(s):  
Mohamed Imam ◽  
Mohamed Shehata ◽  
Mahmoud Morsi ◽  
Muhammad Shawqi ◽  
Ahmed Elsehili ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Older Patients ◽  
Observational Studies ◽  
Meta Analysis ◽  
Hip Hemiarthroplasty ◽  
Uncemented Hemiarthroplasty ◽  
Neck Fracture

Abstract Background Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior. Uncemented prostheses have typically been used in younger, healthier patients and cemented prostheses in older patients with less-stable bone. Also, earlier research has suggested that bone cement has cytotoxic effects and may trigger cardiovascular and respiratory adverse events. Questions/Purposes The aim of this systematic review and meta-analysis was to compare morbidity and mortality rates after cemented and uncemented hemiarthroplasty for the treatment of displaced femoral neck fractures in elderly patients. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven medical databases for randomized clinical trials and observational studies. We compared cemented and uncemented hemiarthroplasty using the Harris Hip Score (HHS), as well as measures of postoperative pain, mortality, and complications. Data were extracted and pooled as risk ratios or standardized mean difference with their corresponding 95% confidence intervals in a meta-analysis model. Results The meta-analysis included 34 studies (12 randomized trials and 22 observational studies), with a total of 42,411 patients. In the pooled estimate, cemented hemiarthroplasty was associated with less risk of postoperative pain than uncemented hemiarthroplasty. There were no significant differences between groups regarding HHS or rates of postoperative mortality, pulmonary embolism, cardiac arrest, myocardial infarction, acute cardiac arrhythmia, or deep venous thrombosis. Conclusions While we found that cemented hemiarthroplasty results in less postoperative pain than uncemented hemiarthroplasty in older patients with femoral neck fracture, the lack of significant differences in functional hip scores, mortality, and complications was surprising. Further high-level research is needed.

Avascular Necrosis of the Femoral Head After Femoral Neck Fracture

2002 ◽  
Vol 399 ◽  
pp. 87-109 ◽  
Author(s):  
Fernando G??mez-Castresana Bachiller ◽  
Antonio Perez Caballer ◽  
Luis Ferr??ndez Portal
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Avascular Necrosis ◽  
Neck Fracture
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