Prediction of disturbed healing in femoral neck fracture

Abstract

To determine factors predictive of early healing disturbances after fixation of femoral neck fracture, the radiographic and clinical data of 149 patients were subjected to a logistic regression analysis comparing them with the results 3 months postoperatively. As in previous studies, fracture reduction distinguished between fractures with or without healing disturbances. The following signs in the preoperative radiographs were predictive of unfavorable outcome: small head fragment, comminution of the calcar femorale, and varus angulation of the head. Fractures with negative predictive signs may be selected for primary arthroplasty.

Outcome of undisplaced and moderately displaced femoral neck fractures

“…All physicians were familiar with the radiographic criteria of Alho et al (1992). We have previously conducted a study investigating the interobserver reliability of the criteria (Bjorgul and Reikeras 2002) and found that the kappa values for the specific criteria showed low to moderate values.…”

“…In the displaced fracture, the degree of comminution of the femoral calcar, the size of the head fragment, and the degree of varus angular displacement may predict the healing potential of the fracture (Alho et al 1991(Alho et al , 1992. However, the optimal treatment for fractures with better healing potential (i.e.…”

Prediction of fixation failure in femoral neck fractures: Comminution and avascularity studied in 40 patients

“…The first 2 types of disturbed healing were not necessarily imcompatible with maintained function, but were highly predictive of later failure (Benterud et al 1993). The pretreatment radiographs were analyzed for fracture displacement and comminution of the calcar, which in our previous studies were predictive of early failure (Alho et al 1991(Alho et al , 1992. The later radiographs were also analyzed for late signs of' avascular necrosis (Calandruccio and Anderson 1980).…”

“…The prognostic significance of 9 y m T~ phosphonate scintimetry in femoral neck fractures is well documented (Stromquist et al 1984, Alberts et al 1987, Alberts 1990). Recently, we showed that fracture comminution and displacement also have predictive importance (Alho et al 1991(Alho et al , 1992.…”

Management of a neglected femoral neck fracture – a case report and review of literature

“…These fractures are associated with the complications of fracture displacement or re-displacement after reduction and fixation, non-union and avascular necrosis 4 . Studies have suggested that the greater the degree of initial fracture displacement the greater the risk is for these fracture healing complications to occur 5,6 . Accurate reduction and internal fixation are obligatory requirements to anticipate fracture healing.…”