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Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years

Authors
 Hyung Keun Song  ;  Ho June Choi  ;  Kyu Hyun Yang 
Citation
 INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, Vol.47(12) : 2743-2748, 2016 
Journal Title
 INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 
ISSN
 0020-1383 
Issue Date
2016
MeSH
Aged ; Aged, 80 and over ; Bone Screws ; Coxa Valga/diagnostic imaging ; Coxa Valga/pathology* ; Coxa Valga/surgery ; Female ; Femoral Neck Fractures/diagnostic imaging ; Femoral Neck Fractures/physiopathology ; Femoral Neck Fractures/surgery* ; Femur Head Necrosis/diagnostic imaging ; Femur Head Necrosis/pathology* ; Femur Head Necrosis/surgery ; Fracture Fixation, Internal*/adverse effects ; Fracture Fixation, Internal*/methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures/diagnostic imaging ; Osteoporotic Fractures/physiopathology ; Osteoporotic Fractures/surgery* ; Radiography ; Retrospective Studies ; Treatment Failure ; Treatment Outcome
Keywords
Avascular necrosis ; Femur neck fracture ; Fixation failure ; Screw osteosynthesis ; Valgus angulated
Abstract
INTRODUCTION: The aim of our study was to identify the risk factors for avascular necrosis of the femoral head (AVN) and fixation failure (FF) after screw osteosynthesis in patients with valgus angulated femoral neck fractures. PATIENTS AND METHODS: We conducted a retrospective study of 308 patients (mean age, 72.5 years, range, 50-97 years), with a mean follow-up of 21.4 months (range, 12-64 months). The risk for failure in treatment (FIT) associated with patient- and fracture-related factors was evaluated by logistic regression analyses. RESULTS: FIT was identified in 32 cases (10.3%): 22 cases (7.1%) of AVN and 10 cases (3.2%) of FF. Initial valgus tilt>15° (p=0.023), posterior tilt>15° (p=0.012), and screw sliding distance (p=0.037) were significantly associated with FIT. FIT occurred in 7 patients (5.2%) with B1.2.1 fractures and 17 patients (48.6%) with B1.1.2 fractures (p<0.001). The odds of FIT were 17-fold higher in patients with initial valgus and posterior tilts>15° (B1.1.2) compared to patients with <15° of tilt in both planes (B1.2.1). CONCLUSION: The severity of initial deformity predicts AVN and FF in patients with valgus angulated femoral neck fractures. Patients with an initial valgus and posterior tilt>15° are reasonable candidates for primary arthroplasty due to high risk of FIT.
Full Text
http://www.sciencedirect.com/science/article/pii/S0020138316306726?via%3Dihub
DOI
10.1016/j.injury.2016.10.022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Choi, Ho June(최호준)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152780
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