[Characteristics of femoral neck fractures in young and middle-aged adults based on fracture mapping technology].

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: 利益冲突　在课题研究和文章撰写过程中不存在利益冲突；经费支持没有影响文章观点和对研究数据客观结果的分析及其报道 15. Clin Orthop Surg. 2024 Oct;16(5):718-723. doi: 10.4055/cios24089. Epub 2024 Aug 5. The Effects and Risk Factors of Femoral Neck Shortening after Internal Fixation of Femoral Neck Fractures. Lee DH(1), Kwon JH(1), Kim KC(1). Author information: (1)Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. BACKGROUD: Internal fixation has been established as a treatment of choice in relatively young patients with femoral neck fractures. Due to the characteristics of femoral neck anatomy and blood supply, complications such as malunion, nonunion, avascular necrosis, and femoral neck shortening can occur after internal fixation of femoral neck fractures. Unlike other complications such as avascular necrosis or nonunion, femoral neck shortening has not been relatively well studied. This study aimed to investigate the risk factors and clinical outcomes of femoral neck shortening after internal fixation of femoral neck fractures. METHODS: From June 2012 to July 2022, among 102 patients who underwent internal fixation of femoral neck fractures, 94 patients who met inclusion and exclusion criteria were retrospectively analyzed. Internal fixation of the femoral neck was done with cannulated compression screws or a femoral neck system. Patients were divided into 2 groups; femoral neck shortening (≥ 5 mm) and no shortening (< 5 mm) according to measurement on follow-up hip anteroposterior (AP) simple radiographs compared with postoperative hip AP simple radiographs. Demographic and radiographic data were compared between the 2 groups. The modified Harris Hip Score (mHHS) and a visual analog scale (VAS) were used to evaluate the clinical outcomes. RESULTS: Among 94 patients, femoral neck shortening was observed in 33 (35.1%). In chi-square test, Pauwels angle, Garden type III or IV (displacement), and cortical comminution were significantly correlated with neck shortening (p < 0.05). In the multifactorial logistic regression test, cortical comminution was significantly correlated with femoral neck shortening (p < 0.01). The shortening group showed significantly lower clinical scores in terms of mHHS and VAS (p < 0.01). CONCLUSIONS: The femoral neck shortening group showed significantly lower clinical scores of mHHS and VAS than the no-shortening group. The presence of cortical comminution in preoperative hip computed tomography is a risk factor of femoral neck shortening after internal fixation of femoral neck fractures. Copyright © 2024 by The Korean Orthopaedic Association. DOI: 10.4055/cios24089 PMCID: PMC11444948