The role of the medial buttress plate in the treatment of Pauwels type II and III femoral neck fracture in nonelderly patients: a retrospective study and preliminary results.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that they have no competing interests. 10. J Orthop Sci. 2024 Sep;29(5):1274-1279. doi: 10.1016/j.jos.2023.08.020. Epub 2023 Oct 13. Predicting fracture classification and prognosis with hounsfield units and femoral cortical index: A simple and cost-effective approach. Zhao C(1), Li X(1), Liu P(2), Chen Z(1), Sun G(1), Dai J(3), Wang X(4). Author information: (1)Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, PR China. (2)Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China. (3)Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, PR China. Electronic address: daijingjing9h@163.com. (4)Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, PR China. Electronic address: osteoclast2006@163.com. BACKGROUND: The relationship between bone density and fracture has been widely studied and recognized, and the role of cortical bone in proximal femoral fractures has also been increasingly studied. However, both the determination of bone mineral density (BMD) and the determination of cortical mass are expensive and cumbersome. The purpose of this study is to investigate whether two readily available indicators, Hounsfield Units (HUs) and femoral cortical index (FCI), can be used to predict hip fracture classification and prognosis. METHODS: A retrospective study was conducted on 110 patients with hip fragility fractures. Cortical index was calculated on fractured and contralateral femur FCI, with HUs calculated on the proximal femur. The correlation of the FCI and HU with diabetes, hypertension, and related indicators, such as albumin, creatinine, and urea nitrogen levels, were also analyzed in the study. RESULTS: Both the Evans classification of intertrochanteric fractures and the Garden and Pauwels classifications of femoral neck fractures showed that as the severity of the fracture increased, the HUs and FCI decreased. Age and albumin level also had a negative correlation with HUs and FCI. There was also a significant correlation between HUs and FCI. CONCLUSIONS: The HUs and FCI, which can be easily and quickly obtained, can be used to predict the classification and prognosis of hip fractures. Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.jos.2023.08.020