Analysis on risk factors for neck shortening after internal fixation for Pauwels II femoral neck fracture in young patients

Abstract Background Femoral neck shortening can occur in young patients receiving internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after internal fixation with parallel partially threaded cannulated cancellous screws (FPTCS) for Pauwels type II femoral neck fracture in relatively young patients. Methods Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. And the Chi-squared test or Fisher’s exact test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after internal fixation with FPTCS for Pauwels type II femoral neck fracture in young patients. BMD and BMI may be also risk factors.

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Analysis on risk factors for neck shortening after internal fixation for Pauwels II femoral neck fracture in young patients

10.21203/rs.3.rs-29466/v2 ◽

2021 ◽

Author(s):

Fulong Zhao ◽

Lijuan Guo ◽

xuefei wang ◽

Yakui Zhang

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Young Patients ◽

Type Ii ◽

Fracture Type ◽

Medial Cortex ◽

Neck Fracture

Abstract Background: Femoral neck shortening can occur in young patients receiving internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after internal fixation with parallel partially threaded cannulated cancellous screws (FPTCS) for Pauwels type II femoral neck fracture in relatively young patients. Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. And the chi-squared test or Fisher’s exact test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after internal fixation with FPTCS for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.

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Analysis on Risk Factors for Neck Shortening After Internal Fixation for Pauwels II Femoral Neck Fracture in Young Patients

10.21203/rs.3.rs-37195/v1 ◽

2020 ◽

Author(s):

Fulong Zhao ◽

Lijuan Guo ◽

xuefei wang ◽

Yakui Zhang

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Young Patients ◽

Type Ii ◽

Fracture Type ◽

Medial Cortex ◽

Neck Fracture ◽

Cancellous Screws

Abstract Background:Femoral neck shortening can occur in in young patients receiving internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in relatively young patients. Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. And the chi-squared test or Fisher’s exact test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.

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Analysis on risk factors for neck shortening after internal fixation for Pauwels type II femoral neck fracture in young patients

10.21203/rs.3.rs-29466/v1 ◽

2020 ◽

Author(s):

Fulong Zhao ◽

Lijuan Guo ◽

xuefei wang ◽

Yakui Zhang

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Young Patients ◽

Type Ii ◽

Fracture Type ◽

Medial Cortex ◽

Neck Fracture ◽

Cancellous Screws

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Analysis on risk factors for neck shortening after internal fixation for Pauwels II femoral neck fracture in young patients

10.21203/rs.3.rs-37195/v2 ◽

2020 ◽

Author(s):

Fulong Zhao ◽

Lijuan Guo ◽

xuefei wang ◽

Yakui Zhang

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Closed Reduction ◽

Young Patients ◽

Type Ii ◽

Fracture Type ◽

Medial Cortex ◽

Neck Fracture

Abstract Background: Femoral neck shortening can occur in young patients receiving closed reduction and internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after closed reduction and internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. These patients were followed (average follow-up: 12 months). And the chi-square test or t test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after closed reduction and internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.

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Factors Predisposing to Healing Complications After Internal Fixation of Femoral Neck Fracture A Stepwise Logistic Regression Analysis

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199008000-00023 ◽

1990 ◽

Vol &NA; (257) ◽

pp. 129???133 ◽

Cited By ~ 1

Author(s):

KARL AKKE ALBERTS ◽

JACOB JERVAEUS

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Logistic Regression Analysis ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Neck Fracture

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The Probability of and Risk Factors for Femoral Neck Shortening and Internal Fixation Failure After Femoral Neck Fracture Treatment Using Cannulated Screws Combined With a Medial Buttress Plate

10.21203/rs.3.rs-184031/v1 ◽

2021 ◽

Author(s):

Jinglei Xu ◽

Xue Bai ◽

Chenyang Xu ◽

Xianzhong Ma

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Fracture Site ◽

Cannulated Screws ◽

Fixation Failure ◽

Neck Fracture ◽

Buttress Plate

Abstract Background: A range of postoperative complications make femoral neck fracture difficult to treat. Femoral neck shortening and internal fixation failure are two most prevalent complications associated with many surgical strategies. This study evaluates the probability of and risk factors for these complications after the treatment of femoral neck fracture using cannulated screws combined with a medial buttress plate.Methods: Data of 70 patients with femoral neck fractures treated using cannulated screws combined with a medial buttress plate in our hospital between March 2016 and March 2019 were retrospectively analyzed, and 40 patients who were followed up for more than 3 months were enrolled in the study. We evaluated the probability of postoperative femoral neck shortening and internal fixation failure and conducted multivariate logistic regression analysis to determine risk factors.Results: All 40 patients had Garden III/IV or Pauwels II/III fractures. Of these patients, 11 had femoral neck shortening greater than 5 mm and 8 had fracture nonunion or screw cutout requiring reoperation. There were no differences in age, sex, fracture site, Pauwels classification, and reduction quality between the shortening and non-shortening groups; however, there were significant differences in screw quality. Similarly, there were no differences in age, sex, Pauwels classification, reduction quality, and screw quality between the fixation failure and non-failure groups, but there were significant differences in fracture site and shortening. According to the multivariate analyses, screw quality was an independent risk factor for femoral neck shortening (odds ratio [OR]: 8.58; 95% confidence interval [CI]: 1.35–50.57; P=0.022), and femoral neck shortening was an independent risk factor for internal fixation failure (OR: 11.82; 95% CI: 1.66–84.36; P=0.014).Conclusions: Femoral neck fracture treatment using cannulated screws combined with a medial buttress plate led to a femoral neck shortening rate lower than that of other internal fixation methods and an internal fixation failure rate lower than or equivalent to that of other internal fixation methods. The quality of cannulated screws is a risk factor for postoperative shortening of the femoral neck, and femoral neck shortening is a risk factor for postoperative internal fixation failure.

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Incidence of Radiographic Cam-Type Impingement in Young Patients (<50) After Femoral Neck Fracture Treated with Reduction and Internal Fixation

HSS Journal ® ◽

10.1007/s11420-012-9325-5 ◽

2013 ◽

Vol 9 (2) ◽

pp. 113-117 ◽

Cited By ~ 9

Author(s):

Matthew C. Wendt ◽

Joseph R. Cass ◽

Robert R. Trousdale

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Young Patients ◽

Neck Fracture

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The Probability of And Risk Factors For Femoral Neck Shortening And Internal Fixation Failure After Femoral Neck Fracture Treatment Using Cannulated Screws Combined With A Medial Buttress Plate

10.21203/rs.3.rs-184031/v2 ◽

2021 ◽

Author(s):

Jinglei Xu ◽

Xue Bai ◽

Chenyang Xu ◽

Xianzhong Ma

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Independent Risk Factor ◽

Cannulated Screws ◽

Fixation Failure ◽

Neck Fracture ◽

Buttress Plate

Abstract Background: Femoral neck shortening and internal fixation failure are two most prevalent complications associated with surgical treatment of femoral neck fracture. This study evaluates the probability of and risk factors for these complications after the treatment of femoral neck fracture using cannulated screws combined with a medial buttress plate.Methods: Data of 70 patients with femoral neck fractures treated using cannulated screws combined with a medial buttress plate in our hospital between March 2016 and March 2019 were retrospectively analyzed, and 40 patients who were followed up for no less than 6 months were enrolled in the study. We evaluated the probability of postoperative femoral neck shortening and internal fixation failure and conducted multivariate logistic regression analysis to determine risk factors.Results: Among 40 patients, 11 had femoral neck shortening＞5 mm and 8 had fracture nonunion or screw cutout. There were significant differences in screw quality between the shortening and non-shortening groups; There were significant differences in fracture site and shortening between the fixation failure and non-failure groups. According to the multivariate analysis, screw quality was an independent risk factor for femoral neck shortening (odds ratio [OR]: 8.58; 95% confidence interval [CI]: 1.35–50.57; P=0.022), and femoral neck shortening was an independent risk factor for internal fixation failure (OR: 11.82; 95% CI: 1.66–84.36; P=0.014).Conclusions: Femoral neck fracture treatment using cannulated screws combined with a medial buttress plate led to a femoral neck shortening rate lower than that of other internal fixation methods and an internal fixation failure rate lower than or equivalent to that of other internal fixation methods. The quality of cannulated screws is a risk factor for postoperative shortening of the femoral neck, and femoral neck shortening is a risk factor for postoperative internal fixation failure.

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Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

Orvosi Hetilap ◽

10.1556/oh.2008.28228 ◽

2008 ◽

Vol 149 (11) ◽

pp. 493-503 ◽

Cited By ~ 6

Author(s):

Andor Sebestyén ◽

Imre Boncz ◽

Ferenc Tóth ◽

Márta Péntek ◽

József Nyárády ◽

...

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Elderly Patients ◽

Femoral Neck Fracture ◽

Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

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Combination of CRP with NLR is a sensitive tool for screening fixation-related infection in patients undergoing conversion total hip arthroplasty after failed internal fixation for femoral neck fracture

The Bone & Joint Journal ◽

10.1302/0301-620x.103b.bjj-2021-0105.r1 ◽

2021 ◽

pp. 1-7

Author(s):

Hong Xu ◽

Jin-Wei Xie ◽

Li Liu ◽

Duan Wang ◽

Ze-Yu Huang ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fracture ◽

Sensitivity And Specificity ◽

Hip Arthroplasty ◽

Lymphocyte Ratio ◽

Total Hip ◽

Sensitive Tool ◽

Neck Fracture

Aims Monocyte-lymphocyte ratio (MLR) or neutrophil-lymphocyte ratio (NLR) are useful for diagnosing periprosthetic joint infection (PJI), but their diagnostic values are unclear for screening fixation-related infection (FRI) in patients for whom conversion total hip arthroplasty (THA) is planned after failed internal fixation for femoral neck fracture. Methods We retrospectively included 340 patients who underwent conversion THA after internal fixation for femoral neck fracture from January 2008 to September 2020. Those patients constituted two groups: noninfected patients and patients diagnosed with FRI according to the 2013 International Consensus Meeting Criteria. Receiver operating characteristic (ROC) curves were used to determine maximum sensitivity and specificity of these two preoperative ratios. The diagnostic performance of the two ratios combined with preoperative CRP or ESR was also evaluated. Results The numbers of patients with and without FRI were 19 (5.6%) and 321 (94.4%), respectively. Areas under the ROC curve for diagnosing FRI were 0.763 for MLR, 0.686 for NLR, 0.905 for CRP, and 0.769 for ESR. Based on the Youden index, the optimal predictive cutoffs were 0.25 for MLR and 2.38 for NLR. Sensitivity and specificity were 78.9% and 71.0% for MLR, and 78.9% and 56.4% for NLR, respectively. The combination of CRP with MLR showed a sensitivity of 84.2% and specificity of 94.6%, while the corresponding values for the combination of CRP with NLR were 89.5% and 91.5%, respectively. Conclusion The presence of preoperative FRI among patients undergoing conversion THA after internal fixation for femoral neck fracture should be determined. The combination of preoperative CRP with NLR is sensitive tool for screening FRI in those patients.

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