当前位置： SCI文献检索 > BMC MUSCULOSKELETAL DISORDERS期刊下所有文献 > Suboptimal outcomes after closed reduction and internal fixation of displaced femoral neck fractures in middle-aged patients: is internal fixation adequate in this age group?

Suboptimal outcomes after closed reduction and internal fixation of displaced femoral neck fractures in middle-aged patients: is internal fixation adequate in this age group?

Abstract：

BACKGROUND:There have been many studies regarding nongeriatric femoral neck fractures (FNFs), which included patients of a wide age range (between 20 and 60 years old). We aimed to determine whether internal fixation provided acceptable outcomes for middle-aged patients with displaced FNFs, and identify predictors of successful internal fixation. METHODS:A total of 117 patients, aged 50-60 years and who underwent closed reduction and unilateral internal fixation using cannulated screws, were included. The outcomes were classified as either "complications" (varus malunion, femoral neck shortening, non-union/early collapse, avascular necrosis, or arthroplasty during the follow-up) or "optimal outcomes" (no complications). Patients with displaced FNFs (Garden stages III-IV, n = 69) were categorized according to whether they experienced acceptable or unacceptable reduction. We evaluated whether patients' clinical characteristics could predict optimal outcomes. RESULTS:Patients with displaced FNFs generally experienced complications (84.1%). Twenty-two percent of patients experienced optimal outcomes when acceptable reduction was achieved. Patients with unacceptable reductions experienced complications. Optimal outcomes were positively associated with Pauwels' type II fracture (OR: 8.67, p = 0.025) and negatively associated with excessive alcohol consumption (p = 0.045). CONCLUSIONS:Compared with the younger age group, complication rates are higher in middle-aged patients with displaced FNFs treated using cannulated screws. If internal fixation is to be used for a displaced FNF, patient selection is essential. Care must be taken to avoid selecting patients with excessive alcohol consumption, while successful internal fixation may be more likely for patients with Pauwels' type II fracture.

journal_name

BMC Musculoskelet Disord

journal_title

BMC musculoskeletal disorders

authors

Wang CT,Chen JW,Wu K,Chen CS,Chen WC,Pao JL,Chang CH,Lan TY

doi

10.1186/s12891-018-2120-9

subject

Has Abstract

pub_date

2018-06-09 00:00:00

pages

190

issue

issn

1471-2474

pii

10.1186/s12891-018-2120-9

journal_volume

pub_type

杂志文章

在线工具

Suboptimal outcomes after closed reduction and internal fixation of displaced femoral neck fractures in middle-aged patients: is internal fixation adequate in this age group?