Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing?
<i>Background and Objectives:</i> The aim of this study was to compare the effect of valgus versus anatomic reduction on internal fixation of Garden type III femoral neck fractures using the sliding hip screw (SHS) and anti-rotation screw (ARS) regarding the radiographic and therapeutic...
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MDPI AG
2022-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/11/1573 |
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| author | Simon Hackl Christian von Rüden Ferdinand Weisemann Isabella Klöpfer-Krämer Fabian M. Stuby Florian Högel |
| author_facet | Simon Hackl Christian von Rüden Ferdinand Weisemann Isabella Klöpfer-Krämer Fabian M. Stuby Florian Högel |
| author_sort | Simon Hackl |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> The aim of this study was to compare the effect of valgus versus anatomic reduction on internal fixation of Garden type III femoral neck fractures using the sliding hip screw (SHS) and anti-rotation screw (ARS) regarding the radiographic and therapeutic outcome. <i>Patients and Methods:</i> A retrospective case-controlled study was performed in a level I trauma center. All patients between 2006 and 2020 aged younger than 70 years with a Garden type III femoral neck fracture and a Kellgren–Lawrence score under grade III stabilized using SHS and ARS were identified. One-hundred and nine patients were included, with a group distribution of sixty-eight patients in group A (anatomic reduction) and forty-one patients in group B (valgus reduction). <i>Results:</i> Mean age was 55 years, and the mean Kellgren–Lawrence score was 1 in both groups. Mean femoral neck angle was 130.5 ± 3.8° in group A and 142.8 ± 4.3° in group B (<i>p</i> = 0.001), with an over-correction of 12° in group B. Tip-apex distance was 10.0 ± 2.8 mm in group A versus 9.3 ± 2.8 mm in group B (<i>p</i> = 0.89). Healing time was 9 weeks in group A compared to 12 weeks in group B (<i>p</i> = 0.001). Failure rate was 4.4% in group A and 17.1% in group B (<i>p</i> = 0.027). <i>Conclusions:</i> Anatomic reduction of Garden type III femoral neck fractures in patients younger than 70 years treated using SHS and ARS resulted in significantly lower failure rates and shorter healing times than after valgus reduction. Therefore, it can be recommended to achieve anatomic reduction. |
| first_indexed | 2024-03-09T18:52:06Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T18:52:06Z |
| publishDate | 2022-11-01 |
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| series | Medicina |
| spelling | doaj.art-9efffa4c264747b9aab6d5034792e3b92023-11-24T05:47:01ZengMDPI AGMedicina1010-660X1648-91442022-11-015811157310.3390/medicina58111573Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing?Simon Hackl0Christian von Rüden1Ferdinand Weisemann2Isabella Klöpfer-Krämer3Fabian M. Stuby4Florian Högel5Department of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyInstitute for Biomechanics, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, Germany<i>Background and Objectives:</i> The aim of this study was to compare the effect of valgus versus anatomic reduction on internal fixation of Garden type III femoral neck fractures using the sliding hip screw (SHS) and anti-rotation screw (ARS) regarding the radiographic and therapeutic outcome. <i>Patients and Methods:</i> A retrospective case-controlled study was performed in a level I trauma center. All patients between 2006 and 2020 aged younger than 70 years with a Garden type III femoral neck fracture and a Kellgren–Lawrence score under grade III stabilized using SHS and ARS were identified. One-hundred and nine patients were included, with a group distribution of sixty-eight patients in group A (anatomic reduction) and forty-one patients in group B (valgus reduction). <i>Results:</i> Mean age was 55 years, and the mean Kellgren–Lawrence score was 1 in both groups. Mean femoral neck angle was 130.5 ± 3.8° in group A and 142.8 ± 4.3° in group B (<i>p</i> = 0.001), with an over-correction of 12° in group B. Tip-apex distance was 10.0 ± 2.8 mm in group A versus 9.3 ± 2.8 mm in group B (<i>p</i> = 0.89). Healing time was 9 weeks in group A compared to 12 weeks in group B (<i>p</i> = 0.001). Failure rate was 4.4% in group A and 17.1% in group B (<i>p</i> = 0.027). <i>Conclusions:</i> Anatomic reduction of Garden type III femoral neck fractures in patients younger than 70 years treated using SHS and ARS resulted in significantly lower failure rates and shorter healing times than after valgus reduction. Therefore, it can be recommended to achieve anatomic reduction.https://www.mdpi.com/1648-9144/58/11/1573femoral neck fractureGarden classificationsliding hip screwanti-rotation screwvalgus reductionKellgren–Lawrence score |
| spellingShingle | Simon Hackl Christian von Rüden Ferdinand Weisemann Isabella Klöpfer-Krämer Fabian M. Stuby Florian Högel Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? Medicina femoral neck fracture Garden classification sliding hip screw anti-rotation screw valgus reduction Kellgren–Lawrence score |
| title | Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? |
| title_full | Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? |
| title_fullStr | Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? |
| title_full_unstemmed | Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? |
| title_short | Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing? |
| title_sort | internal fixation of garden type iii femoral neck fractures with sliding hip screw and anti rotation screw does increased valgus improve healing |
| topic | femoral neck fracture Garden classification sliding hip screw anti-rotation screw valgus reduction Kellgren–Lawrence score |
| url | https://www.mdpi.com/1648-9144/58/11/1573 |
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