Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study
Abstract Background A understanding of morphological characteristics are important to femoral neck fractures (FNFs) resulting in high rates of complications in the young and middle-aged adults and the detailed data is lack in the literature. We aimed to report on the detailed morphological character...
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| Format: | Article |
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BMC
2024-01-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07207-5 |
| _version_ | 1797276227194585088 |
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| author | Yingzhe Jin Bohao Yin Linyuan Shu Zhiyuan Fan Matthew C. Sherrier Chenjun Liu Hui Sun Wei Zhang |
| author_facet | Yingzhe Jin Bohao Yin Linyuan Shu Zhiyuan Fan Matthew C. Sherrier Chenjun Liu Hui Sun Wei Zhang |
| author_sort | Yingzhe Jin |
| collection | DOAJ |
| description | Abstract Background A understanding of morphological characteristics are important to femoral neck fractures (FNFs) resulting in high rates of complications in the young and middle-aged adults and the detailed data is lack in the literature. We aimed to report on the detailed morphological characteristics and the relationship between them in young and middle-aged adults with femoral neck fractures (FNFs). Methods The postoperative CT images of one hundred and fifty-two adults with FNFs were retrospectively reviewed. After image standardization, morphological characteristics including fracture orientation, cortex comminution, and intraosseous bone defects were measured and analyzed. Additionally, the distribution and correlation of these morphological features were analyzed using Pauwels classification, the right angle of the neck axis (VNA) classification, and the anteromedial oblique angle (AMA). Results Pauwels III fractures accounted for approximately half (55.2%) of the FNFs analyzed. Pauwels II and III could be detected in all four VNA types, and the distribution of the Pauwels types in VNA classification showed significant differences (χ2 = 106.363, p < 0.001). The VNA (9.0° ± 12.1) showed positive correlation with the neck-shaft angle (139.5° ± 6.3) and modified Pauwels angle (49.8° ± 10.6) (r = 0.441, r = 0.855, all p < 0.001). Cortical comminutions were commonly observed in the posterior (86.7%) and the inferior (80.7%). AMAs within the cases without posterior and inferior cortex comminutions were significantly larger than those with comminution (t = 2.594, 2.1196; p = 0.01, 0.036), but no difference could be detected after the AMA being divided into three groups (< 85°, 85°-95°, > 95°). The MPA, VNA and AMA of the group with an intraosseous defect were significantly different compared with those without (t = 2.847, 2.314, 2.268; p = 0.005, 0.022,0.025). The incidence of intraosseous defects within the groups with coronal and axial cortex comminutions were significantly higher than those within the groups without comminutions (χ2 = 34.87, 25.303; p < 0.001). Conclusions The present study highlights the morphological diversity and complexity within FNFs in young and middle-aged adults, which allows for more accurate simulation of FNF patterns in the future biomechanical studies. |
| first_indexed | 2024-03-07T15:25:20Z |
| format | Article |
| id | doaj.art-edc7d40d989b4a63bab99d53577fea49 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-07T15:25:20Z |
| publishDate | 2024-01-01 |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-edc7d40d989b4a63bab99d53577fea492024-03-05T17:24:12ZengBMCBMC Musculoskeletal Disorders1471-24742024-01-0125111210.1186/s12891-024-07207-5Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive studyYingzhe Jin0Bohao Yin1Linyuan Shu2Zhiyuan Fan3Matthew C. Sherrier4Chenjun Liu5Hui Sun6Wei Zhang7Orthopedic Department, The Affiliated Lihuili Hospital of Ningbo UniversityDepartment of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Emergency Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedics and Physical Medicine, Medical University of South CarolinaDepartment of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineAbstract Background A understanding of morphological characteristics are important to femoral neck fractures (FNFs) resulting in high rates of complications in the young and middle-aged adults and the detailed data is lack in the literature. We aimed to report on the detailed morphological characteristics and the relationship between them in young and middle-aged adults with femoral neck fractures (FNFs). Methods The postoperative CT images of one hundred and fifty-two adults with FNFs were retrospectively reviewed. After image standardization, morphological characteristics including fracture orientation, cortex comminution, and intraosseous bone defects were measured and analyzed. Additionally, the distribution and correlation of these morphological features were analyzed using Pauwels classification, the right angle of the neck axis (VNA) classification, and the anteromedial oblique angle (AMA). Results Pauwels III fractures accounted for approximately half (55.2%) of the FNFs analyzed. Pauwels II and III could be detected in all four VNA types, and the distribution of the Pauwels types in VNA classification showed significant differences (χ2 = 106.363, p < 0.001). The VNA (9.0° ± 12.1) showed positive correlation with the neck-shaft angle (139.5° ± 6.3) and modified Pauwels angle (49.8° ± 10.6) (r = 0.441, r = 0.855, all p < 0.001). Cortical comminutions were commonly observed in the posterior (86.7%) and the inferior (80.7%). AMAs within the cases without posterior and inferior cortex comminutions were significantly larger than those with comminution (t = 2.594, 2.1196; p = 0.01, 0.036), but no difference could be detected after the AMA being divided into three groups (< 85°, 85°-95°, > 95°). The MPA, VNA and AMA of the group with an intraosseous defect were significantly different compared with those without (t = 2.847, 2.314, 2.268; p = 0.005, 0.022,0.025). The incidence of intraosseous defects within the groups with coronal and axial cortex comminutions were significantly higher than those within the groups without comminutions (χ2 = 34.87, 25.303; p < 0.001). Conclusions The present study highlights the morphological diversity and complexity within FNFs in young and middle-aged adults, which allows for more accurate simulation of FNF patterns in the future biomechanical studies.https://doi.org/10.1186/s12891-024-07207-5Femoral neck fracturePostoperative CTIntraosseous bone defectsClassificationMorphology |
| spellingShingle | Yingzhe Jin Bohao Yin Linyuan Shu Zhiyuan Fan Matthew C. Sherrier Chenjun Liu Hui Sun Wei Zhang Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study BMC Musculoskeletal Disorders Femoral neck fracture Postoperative CT Intraosseous bone defects Classification Morphology |
| title | Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study |
| title_full | Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study |
| title_fullStr | Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study |
| title_full_unstemmed | Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study |
| title_short | Morphological characteristics of femoral neck fractures in young and middle-aged population: a retrospective descriptive study |
| title_sort | morphological characteristics of femoral neck fractures in young and middle aged population a retrospective descriptive study |
| topic | Femoral neck fracture Postoperative CT Intraosseous bone defects Classification Morphology |
| url | https://doi.org/10.1186/s12891-024-07207-5 |
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