Risk Factors Associated with Femoral Neck Fracture Outcomes in Adults: Retrospective Clinical Study
Istanbul Medical Journal, cilt.23, sa.3, ss.189-193, 2022 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 23 Sayı: 3
- Basım Tarihi: 2022
- Doi Numarası: 10.4274/imj.galenos.2022.85453
- Dergi Adı: Istanbul Medical Journal
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.189-193
- Anahtar Kelimeler: Femoral neck fractures, internal fixation, time to surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: The aim of this study was to evaluate the factors affecting the clinical and radiological results of the patients who underwent internal fixation due to femoral neck. Methods: Sixty-nine patients are included in this study. Follow-up periods were determined as a minimum of six months. Fractures were classified with Garden and Pauwel’s classifications. 12 hours was the cut-off limit between early and delayed fixation. The standard treatment was cannulated screw fixation. Trauma mechanism, reduction quality and patient dependent factors such as smoking and diabetes were evaluated. Non-union and avascular necrosis (AVN) was diagnosed with X-ray or computerized tomography if needed. Harris Hip score (HHS) was used as a functional scoring modality. Results: Twenty-five (36.2%) patients were female and 44 (63.8%) were male. Twenty-six patients (37.7%) were under 40 years old and 43 (62.3%) were older. Forty-two (60.9%) of these fractures were classified as Garden 1-2 (non-displaced) and 27 (39.1%) were classified as Garden 3-4 (displaced). While 39 patients (56.5%) were operated on before the 12-hour cut-off point; 30 patients (43.5%) were operated on later. Fourteen patients (20.3%) were diagnosed with non-union and 12 (17.4%) with AVN. Mean HHS was 88.7±14.2 (47-100). Displaced group (Garden 3-4) showed a higher incidence of non-union (40.7% vs.7.1%) and AVN (25.9% vs. 11.9%) compared to the non-displaced group (Garden 1-2). The timing of surgery did not have a statistically significant impact on outcome in terms of non-union and AVN. The complication rates were higher in patients with poor reduction. Conclusion: Our complication rates were similar to the literature. Age, gender, fracture side, smoking, and time to fixation were found as irrelevant with non-union and AVN rates. Non-union was significantly higher in the displaced group and no significant difference was found in AVN rates. The reduction quality was significantly associated with complications.