The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head
Abstract Background Hollow screw internal fixation is commonly used in clinical treatment of impacted femoral neck fractures. Previous studies have demonstrated a correlation between the preoperative posterior tilt angle of the femoral head and failure of internal fixation, but there are fewer studi...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06874-0 |
| _version_ | 1797578629783224320 |
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| author | Bo Cong Haiguang Zhang |
| author_facet | Bo Cong Haiguang Zhang |
| author_sort | Bo Cong |
| collection | DOAJ |
| description | Abstract Background Hollow screw internal fixation is commonly used in clinical treatment of impacted femoral neck fractures. Previous studies have demonstrated a correlation between the preoperative posterior tilt angle of the femoral head and failure of internal fixation, but there are fewer studies related to the occurrence of postoperative femoral head necrosis and the posterior tilt angle. Methods To examine the relationship between three-dimensional posterior tilt angle measurements in affected femoral neck fractures and postoperative osteonecrosis of the femoral head and related risk variables. We retrospectively examined 130 Yantaishan Hospital patients with affected femoral neck fractures from 2019 to 2022. Three-dimensional reconstruction technology assessed the posterior tilt angle of the femoral head and separated patients into necrosis and non-necrosis groups based on postoperative femoral head necrosis. Univariate analysis compared clinical data between groups, and multivariate logistic regression analyzed risk variables for femoral head necrosis. Postoperative femoral head necrosis was predicted by posterior tilt angle using Receiver operating characteristic (ROC) curve analysis. Results Out of 130 patients who were followed up for 16–68 months postoperatively, 20 developed femoral head necrosis. Multivariate logistic regression analysis indicated that the posterior tilt angle and reduction quality level C were risk factors for the occurrence of femoral head necrosis. The ROC curve analysis showed that the three-dimensional measurement of the posterior tilt angle had predictive value for postoperative femoral head necrosis, with a cut-off value of 20.6°. Conclusions These results suggest that, for patients with impacted femoral neck fractures, the posterior tilt angle and reduction quality level C are risk factors for femoral head necrosis following closed reduction and internal fixation surgery. Fracture patients with a posterior tilt angle ≥ 20.6°are more likely to experience postoperative femoral head necrosis. |
| first_indexed | 2024-03-10T22:25:31Z |
| format | Article |
| id | doaj.art-cebb3c7990154bde946fd6f7f6ed49f7 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:25:31Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-cebb3c7990154bde946fd6f7f6ed49f72023-11-19T12:08:37ZengBMCBMC Musculoskeletal Disorders1471-24742023-09-012411910.1186/s12891-023-06874-0The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral headBo Cong0Haiguang Zhang1Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantaishan Hospital Affiliated to Binzhou Medical University, Laishan DistrictYantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantaishan Hospital Affiliated to Binzhou Medical University, Laishan DistrictAbstract Background Hollow screw internal fixation is commonly used in clinical treatment of impacted femoral neck fractures. Previous studies have demonstrated a correlation between the preoperative posterior tilt angle of the femoral head and failure of internal fixation, but there are fewer studies related to the occurrence of postoperative femoral head necrosis and the posterior tilt angle. Methods To examine the relationship between three-dimensional posterior tilt angle measurements in affected femoral neck fractures and postoperative osteonecrosis of the femoral head and related risk variables. We retrospectively examined 130 Yantaishan Hospital patients with affected femoral neck fractures from 2019 to 2022. Three-dimensional reconstruction technology assessed the posterior tilt angle of the femoral head and separated patients into necrosis and non-necrosis groups based on postoperative femoral head necrosis. Univariate analysis compared clinical data between groups, and multivariate logistic regression analyzed risk variables for femoral head necrosis. Postoperative femoral head necrosis was predicted by posterior tilt angle using Receiver operating characteristic (ROC) curve analysis. Results Out of 130 patients who were followed up for 16–68 months postoperatively, 20 developed femoral head necrosis. Multivariate logistic regression analysis indicated that the posterior tilt angle and reduction quality level C were risk factors for the occurrence of femoral head necrosis. The ROC curve analysis showed that the three-dimensional measurement of the posterior tilt angle had predictive value for postoperative femoral head necrosis, with a cut-off value of 20.6°. Conclusions These results suggest that, for patients with impacted femoral neck fractures, the posterior tilt angle and reduction quality level C are risk factors for femoral head necrosis following closed reduction and internal fixation surgery. Fracture patients with a posterior tilt angle ≥ 20.6°are more likely to experience postoperative femoral head necrosis.https://doi.org/10.1186/s12891-023-06874-0Impacted femoral neck fracturesPosterior tilt angleThree-dimensional reconstructionOsteonecrosis of the femoral headInternal fixationRisk factors |
| spellingShingle | Bo Cong Haiguang Zhang The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head BMC Musculoskeletal Disorders Impacted femoral neck fractures Posterior tilt angle Three-dimensional reconstruction Osteonecrosis of the femoral head Internal fixation Risk factors |
| title | The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| title_full | The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| title_fullStr | The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| title_full_unstemmed | The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| title_short | The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| title_sort | association between three dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head |
| topic | Impacted femoral neck fractures Posterior tilt angle Three-dimensional reconstruction Osteonecrosis of the femoral head Internal fixation Risk factors |
| url | https://doi.org/10.1186/s12891-023-06874-0 |
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