Preoperative posterior tilt of at least 20° increased the risk of fixation failure in Garden-I and -II femoral neck fractures: 322 patients followed for a mean of 3 years
| Autor: | Mina Adampour, Frede Frihagen, Stein Erik Utvåg, Sigurd Erik Hoelsbrekken, Knut Stavem, Filip C. Dolatowski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Orthopedic surgery
030222 orthopedics medicine.medical_specialty business.industry Intraclass correlation medicine.medical_treatment Hazard ratio General Medicine Femoral Neck Fractures Arthroplasty Surgery 03 medical and health sciences Fixation (surgical) Femoral head 0302 clinical medicine medicine.anatomical_structure Fracture fixation Medicine Internal fixation Orthopedics and Sports Medicine 030212 general & internal medicine business RD701-811 |
| Zdroj: | Acta Orthopaedica, Vol 87, Iss 3, Pp 252-256 (2016) Acta Orthopaedica |
| ISSN: | 1745-3674 |
| Popis: | Background and purpose — It has been suggested that preoperative posterior tilt of the femoral head may increase the risk of fixation failure in Garden-I and -II femoral neck fractures. To investigate this association, we studied a cohort of 322 such patients. Patients and methods — Patients treated with internal fixation between 2005 and 2012 were retrospectively identified using hospital records and the digital image bank. 2 raters measured the preoperative posterior tilt angle and categorized it into 3 groups: < 10°, 10–20°, and ≥ 20°. The inter-rater reliability (IRR) was determined. Patients were observed until September 2013 (with a minimum follow-up of 18 months) or until failure of fixation necessitating salvage arthroplasty. The risk of fixation failure was assessed using competing-risk regression analysis, adjusting for time to surgery. Results — Patients with a posterior tilt of ≥ 20° had a higher risk of fixation failure: 19% (8/43) as compared to 11% (14/127) in the 10–20° category and 6% (9/152) in the < 10° category (p = 0.03). Posterior tilt of ≥ 20° increased the risk of fixation failure, with an adjusted hazard ratio of 3.4 (95% CI: 1.3–8.9; p = 0.01). The interclass correlation coefficient for angular measurements of posterior tilt was 0.90 (95% CI: 0.87–0.92), and the IRR for the categorization of posterior tilt into 3 groups was 0.76 (95% CI: 0.69–0.81). Interpretation — Preoperative posterior tilt of ≥ 20° in Garden-I and -II femoral neck fractures increased the risk of fixation failure necessitating salvage arthroplasty. The reliability of the methods that we used to measure posterior tilt ranged from good to excellent. |
| Databáze: | OpenAIRE |
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