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- W2948934400 abstract "Abstract Introduction The aim of our study was to (1) report our surgical outcomes of internal fixation in patients with nondisplaced or valgus impaction fractures of the femoral neck; (2) introduce our new three dimensional assessment method using a combination of X-ray and CT imaging, and (3) determine which radiologic measurements significantly predicted fixation failure. Hypothesis We hypothesized that high posterior tilt angle and retroversion angle are related to high incidence of non-union and osteonecrosis. Materials and methods From January 2009 to December 2016, 64 elderly patients in two institutions with nondisplaced or valgus impaction fractures of the femoral neck who had internal fixation using multiple parallel cannulated screws were enrolled. To determine the independent predictors of non-union, osteonecrosis, and reoperation, various clinical variables and radiologic variables, including the valgus angle on coronal CT images, the posterior tilt angle on Lorenz images, and the retroversion angle on axial CT images, were analyzed. Results Non-union was identified in nine of the 64 patients (14.1%) and nine of the 55 patients (16.4%) who achieved bony union had femoral head osteonecrosis with subsequent segmental collapse. The multiple logistic regression model showed that a low bone mineral density of the femur, a higher posterior tilt angle on Lorenz image, and a higher retroversion angle on axial CT images were independent predictors of non-union and reoperation. Discussion Primary hip arthroplasty should be considered when a posterior tilt angle of more than 9 degrees on Lorenz images or a retroversion angle of more than 13 degrees on axial CT images is identified in patients with osteoporotic valgus impaction fractures. Type of study and level of proof III, retrospective comparative study." @default.
- W2948934400 created "2019-06-14" @default.
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- W2948934400 date "2019-09-01" @default.
- W2948934400 modified "2023-09-23" @default.
- W2948934400 title "Analyse 3D pour prédire les résultats des fractures cervicales fémorales Garden 1 et 2 : une étude rétrospective multicentrique" @default.
- W2948934400 doi "https://doi.org/10.1016/j.rcot.2019.05.001" @default.
- W2948934400 hasPublicationYear "2019" @default.
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