Fractures of the femoral neck in patients between the ages of twelve and forty-nine years.

Swiontkowski, Marc F.; Winquist, Robert A.; Hansen, Sigvard T.

doi:10.2106/00004623-198466060-00003

Cited by 266 publications

(196 citation statements)

References 11 publications

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“…The time interval from injury to surgery was not significantly related to AVN of the femoral head in our study. A few previous studies reported that early surgical treatment is associated with a decreased incidence of AVN [35][36][37], whereas other studies found no significant relationship between the time interval and AVN [27,[38][39][40]. Our results show that transient perfusion defects of the femoral head followed by revascularization in the immediate postoperative period do not cause AVN.…”

Section: Discussioncontrasting

confidence: 41%

Risk Stratification for Avascular Necrosis of the Femoral Head After Internal Fixation of Femoral Neck Fractures by Post-Operative Bone SPECT/CT

Han

Yoon

et al. 2016

Nucl Med Mol Imaging

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Purpose Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN. Methods We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months. Results Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2-10 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively. Conclusions According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients.

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Section: Discussioncontrasting

confidence: 41%

Risk Stratification for Avascular Necrosis of the Femoral Head After Internal Fixation of Femoral Neck Fractures by Post-Operative Bone SPECT/CT

Han

Yoon

et al. 2016

Nucl Med Mol Imaging

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“…However, there are studies that report 8-16% AVN in similar type of fractures. [5,30,[39][40][41] Barnes et al [8] reported an AVN rate of 22% and Ort et al [42] reported an AVN rate of 24% in femoral neck fractures treated by DHS. We found higher rates (30% in our Group II patients with DHS), which may have been caused by selection bias.…”

Section: Discussionmentioning

confidence: 99%

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Kaplan¹,

Akesen²,

Demirağ³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…In 1984 Swiontkowski and colleagues [16] reported low rates of AVN (20 %) and no symptomatic nonunion in 27 patients aged 15-50, and attributed this success to the application of an institutional protocol of "immediate reduction" (within eight hours of diagnosis) and internal fixation with compression. This work labeled femoral neck fractures as "orthopaedic emergencies" in our literature.…”

Section: Surgical Timingmentioning

confidence: 99%

Contemporary management of femoral neck fractures: the young and the old

Forsh

Ferguson

2012

Curr Rev Musculoskelet Med

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The optimal management strategy for femoral neck fractures remains highly debated. The femoral neck is intracapsular and the vascular supply is fragile. Furthermore, the curvature of the proximal femur results in high mechanical stresses through the femoral neck. Poor outcomes of nonunion and avascular necrosis (AVN) are common. This chapter reviews the current evidence with respect to the treatment principles of femoral neck fractures in two distinct patient populations: "young" and "old." Contemporary controversies including surgical timing, choice of implant, arthroplasty options, nonoperative management, capsulotomy, and associated complications will be discussed.

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Fractures of the femoral neck in patients between the ages of twelve and forty-nine years.

Cited by 266 publications

References 11 publications

Risk Stratification for Avascular Necrosis of the Femoral Head After Internal Fixation of Femoral Neck Fractures by Post-Operative Bone SPECT/CT

Risk Stratification for Avascular Necrosis of the Femoral Head After Internal Fixation of Femoral Neck Fractures by Post-Operative Bone SPECT/CT

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Contemporary management of femoral neck fractures: the young and the old

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