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BMC Musculoskeletal Disorders

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Open Access 01-12-2024 | Osteonecrosis of the Femoral Head | Research

The small screw-apex distance is potentially associated with femoral head osteonecrosis in adults with femoral neck fractures treated by closed reduction and percutaneous 3 parallel cannulated screws

Authors: Xiaoxiao Zhou, Shengyang Guo, Wenjun Pan, Linyuan Zhang, Houlin Ji, Yang Yang

Published in: BMC Musculoskeletal Disorders | Issue 1/2024

Abstract

Objective

Femoral neck fractures (FNFs) are among the most common fractures in elderly individuals. Surgery is the main treatment for FNFs, and osteonecrosis of the femoral head (ONFH) is one of the unacceptable complications. This study aimed to assess both the clinical and radiological outcomes in patients with FNFs treated with three parallel cannulated screws and to identify relationship between screws position and ONFH.

Patients and methods

A total of 100 patients who were treated with closed reduction and fixed with 3 parallel cannulated screws met the inclusion criteria between January 2014 and December 2020 at authors’ institution. The follow-up duration, age, sex, affected side, and injury-to-surgery interval were collected; the neck-shaft angle of both hips, screw-apex distance (SAD) and the tip-apex distance (TAD)were measured; and the Garden classification, quality of reduction and presence of ONFH were evaluated.

Results

The sample consisted of 37 males and 63 females, with 60 left and 40 right hips affected. The mean age of patients was 54.93 ± 12.24 years, and the mean follow-up was 56.3 ± 13.38 months. The overall incidence of ONFH was 13%. No significant difference was observed in the incidence of ONFH by affected side, age, fracture displacement, injury-to-surgery interval, neck-shaft angle deviation, or reduction quality. The SAD was significantly shorter in ONFH patients than in normal patients for all three screws (p = 0.02, 0.02, and 0.01, respectively).

Conclusions

The short SAD of all screws is associated with femoral head necrosis of FNFs treated with 3 cannulated screws. The short SAD indicated that screws malpositioning in the weight-bearing area of the femoral head, potentially harming the blood supply and compromising the anchorage of the primary compressive trabeculae in this region.

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Title: The small screw-apex distance is potentially associated with femoral head osteonecrosis in adults with femoral neck fractures treated by closed reduction and percutaneous 3 parallel cannulated screws
Authors: Xiaoxiao Zhou
Shengyang Guo
Wenjun Pan
Linyuan Zhang
Houlin Ji
Yang Yang
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Osteonecrosis of the Femoral Head
Osteonecrosis
Published in: BMC Musculoskeletal Disorders / Issue 1/2024
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-024-07380-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The small screw-apex distance is potentially associated with femoral head osteonecrosis in adults with femoral neck fractures treated by closed reduction and percutaneous 3 parallel cannulated screws

Abstract

Objective

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Patients and methods

Results

Conclusions

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