Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients
Abstract Objective To investigate the distribution and influence of comminution in femoral neck fracture (FNF) patients after cannulated screw fixation (CSF). Methods From January 2019 to June 2020, a total of 473 patients aged 23–65 years with FNF treated by CSF were included in the present study....
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03157-7 |
| _version_ | 1817995756613664768 |
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| author | Zhe Han Wumti Taxi Haobo Jia NengNeng Ji DongDong Cao Xiang Sun Chao Han Mengqi Xie Xinlong Ma Qiang Dong |
| author_facet | Zhe Han Wumti Taxi Haobo Jia NengNeng Ji DongDong Cao Xiang Sun Chao Han Mengqi Xie Xinlong Ma Qiang Dong |
| author_sort | Zhe Han |
| collection | DOAJ |
| description | Abstract Objective To investigate the distribution and influence of comminution in femoral neck fracture (FNF) patients after cannulated screw fixation (CSF). Methods From January 2019 to June 2020, a total of 473 patients aged 23–65 years with FNF treated by CSF were included in the present study. Based on location of the cortical comminution, FNF patients were assigned to two groups: the comminution group (anterior comminution, posterior comminution, superior comminution, inferior comminution, multiple comminutions) or the without comminution group. The incidence of postoperative complications, quality of life and functional outcomes was recorded at 1-year follow-up. Results Comminution was more likely to appear in displaced FNF patients (86.8%) compared with non-displaced FNF patients (8.9%), and the rate of comminution was closely associated with Pauwels classification (3.2% vs 53.5% vs 83.9%, P < 0.05). The incidence of osteonecrosis of the femoral head (ONFH, 11.3% vs 2.9%, P < 0.05), nonunion (7.5% vs 1.7%, P < 0.05), femoral neck shortening (21.6% vs 13.4%, P < 0.05) and internal fixation failure (11.8% vs 2.9%, P < 0.05) was significantly higher in FNF patients with comminutions, especially with multiple comminutions, than those without. Furthermore, there was a significant difference in the Harris hip score (HHS, 85.6 ± 15.6 vs 91.3 ± 10.8, P < 0.05) and EuroQol five dimensions questionnaire (EQ-5D, 0.85 ± 0.17 vs 0.91 ± 0.18, P < 0.05) between FNF patients with comminution and those without. There was no significant difference in Visual analogue scale scores (VAS, 1.46 ± 2.49 vs 1.13 ± 1.80, P > 0.05) between two groups at 1 year post-surgery. Conclusion Comminution is a risk factor for postoperative complications in young- and middle-aged patients with displaced and Pauwels type III FNF who undergo CSF. This can influence the recovery of hip function, thereby impacting quality of life. Further evaluation with a more comprehensive study design, larger sample and long-term follow-up is needed. |
| first_indexed | 2024-04-14T02:12:27Z |
| format | Article |
| id | doaj.art-b572a1e6fc124a59b7d7ae69a70d8711 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T02:12:27Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-b572a1e6fc124a59b7d7ae69a70d87112022-12-22T02:18:24ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-05-0117111010.1186/s13018-022-03157-7Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patientsZhe Han0Wumti Taxi1Haobo Jia2NengNeng Ji3DongDong Cao4Xiang Sun5Chao Han6Mengqi Xie7Xinlong Ma8Qiang Dong9Department of Hip Trauma, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalInstitute of Orthopaedics, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalInstitute of Orthopaedics, Tianjin HospitalDepartment of Hip Trauma, Tianjin HospitalAbstract Objective To investigate the distribution and influence of comminution in femoral neck fracture (FNF) patients after cannulated screw fixation (CSF). Methods From January 2019 to June 2020, a total of 473 patients aged 23–65 years with FNF treated by CSF were included in the present study. Based on location of the cortical comminution, FNF patients were assigned to two groups: the comminution group (anterior comminution, posterior comminution, superior comminution, inferior comminution, multiple comminutions) or the without comminution group. The incidence of postoperative complications, quality of life and functional outcomes was recorded at 1-year follow-up. Results Comminution was more likely to appear in displaced FNF patients (86.8%) compared with non-displaced FNF patients (8.9%), and the rate of comminution was closely associated with Pauwels classification (3.2% vs 53.5% vs 83.9%, P < 0.05). The incidence of osteonecrosis of the femoral head (ONFH, 11.3% vs 2.9%, P < 0.05), nonunion (7.5% vs 1.7%, P < 0.05), femoral neck shortening (21.6% vs 13.4%, P < 0.05) and internal fixation failure (11.8% vs 2.9%, P < 0.05) was significantly higher in FNF patients with comminutions, especially with multiple comminutions, than those without. Furthermore, there was a significant difference in the Harris hip score (HHS, 85.6 ± 15.6 vs 91.3 ± 10.8, P < 0.05) and EuroQol five dimensions questionnaire (EQ-5D, 0.85 ± 0.17 vs 0.91 ± 0.18, P < 0.05) between FNF patients with comminution and those without. There was no significant difference in Visual analogue scale scores (VAS, 1.46 ± 2.49 vs 1.13 ± 1.80, P > 0.05) between two groups at 1 year post-surgery. Conclusion Comminution is a risk factor for postoperative complications in young- and middle-aged patients with displaced and Pauwels type III FNF who undergo CSF. This can influence the recovery of hip function, thereby impacting quality of life. Further evaluation with a more comprehensive study design, larger sample and long-term follow-up is needed.https://doi.org/10.1186/s13018-022-03157-7Femoral neck fractureComminutionCannulated screw fixationComplication |
| spellingShingle | Zhe Han Wumti Taxi Haobo Jia NengNeng Ji DongDong Cao Xiang Sun Chao Han Mengqi Xie Xinlong Ma Qiang Dong Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients Journal of Orthopaedic Surgery and Research Femoral neck fracture Comminution Cannulated screw fixation Complication |
| title | Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients |
| title_full | Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients |
| title_fullStr | Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients |
| title_full_unstemmed | Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients |
| title_short | Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients |
| title_sort | multiple cannulated screw fixation of femoral neck fractures with comminution in young and middle aged patients |
| topic | Femoral neck fracture Comminution Cannulated screw fixation Complication |
| url | https://doi.org/10.1186/s13018-022-03157-7 |
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