Pubfacts - Scientific Publication Data
  • Categories
  • |
  • Journals
  • |
  • Authors
  • Login
  • Categories
  • Journals

Search Our Scientific Publications & Authors

Publications
  • Publications
  • Authors
find publications by category +
Translate page:

Treatment Failure in Femoral Neck Fractures in Adults Less Than 50 Years of Age: Analysis of 492 Patients Repaired at 26 North American Trauma Centers.

Authors:
Cory A Collinge Andrea Finlay Andres Rodriguez-Buitrago Michael J Beltran Phillip M Mitchell Hassan R Mir Michael J Gardner Michael T Archdeacon Paul Tornetta

J Orthop Trauma 2022 06;36(6):271-279

Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA.

Objectives: To assess the operative results of femoral neck fractures (FNFs) in young adults in a large multicenter series, specifically focusing on risk factors for treatment failure.

Design: Large multicenter retrospective cohort series.

Setting: Twenty-six North American Level 1 trauma centers.

Patients: Skeletally mature patients younger than 50 years with displaced and nondisplaced FNFs treated between 2005 and 2017.

Intervention: Operative repair of FNF.

Main Outcome Measurements: The main outcome measure is treatment failure: nonunion and/or failed fixation, osteonecrosis, malunion, and need for subsequent major reconstructive surgery (arthroplasty or proximal femoral osteotomy). Logistic regression models were conducted to examine factors associated with treatment failure.

Results: Of 492 patients with FNFs studied, a major complication and/or subsequent major reconstructive surgery occurred in 45% (52% of 377 displaced fractures and 21% of 115 nondisplaced fractures). Overall, 23% of patients had nonunion/failure of fixation, 12% osteonecrosis type 2b or worse, 15% malunion (>10 mm), and 32% required major reconstructive surgery. Odds of failure were increased with fair-to-poor reduction [odds ratio (OR) = 5.29, 95% confidence interval (CI) = 2.41-13.31], chronic alcohol misuse (OR = 3.08, 95% CI = 1.59-6.38), comminution (OR = 2.63, 95% CI = 1.69-4.13), multiple screw constructs (vs. fixed-angle devices, OR = 1.95, 95% CI = 1.30-2.95), metabolic bone disease (OR = 1.77, 95% CI = 1.17-2.67), and increasing age (OR = 1.03, 95% CI = 1.01-1.06). Women (OR = 0.57, 95% CI = 0.37-0.88), Pauwels angle ≤50 degrees (type 1 or 2; OR = 0.64, 95% CI = 0.41-0.98), or associated femoral shaft fracture (OR = 0.19, 95% CI = 0.10-0.33) had lower odds of failure.

Conclusions: FNFs in adults <50 years old remain a difficult clinical and surgical problem, with 45% of patients experiencing major complications and 32% undergoing subsequent major reconstructive surgery. Risk factors for complications after treatment of displaced FNFs were numerous.

Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Download full-text PDF

Source
http://dx.doi.org/10.1097/BOT.0000000000002355DOI Listing
June 2022

Publication Analysis

Top Keywords

major reconstructive
12
reconstructive surgery
12
95%
9
subsequent major
8
north american
8
large multicenter
8
femoral neck
8
neck fractures
8
492 patients
8
treatment failure
8
osteonecrosis type
4
12% osteonecrosis
4
23% patients
4
fixation 12%
4
nonunion/failure fixation
4
patients nonunion/failure
4
fractures 23%
4
nondisplaced fractures
4
type worse
4
15% malunion
4

Keyword Occurance

Similar Publications

Single Institution Evolution in Defining an Algorithm for Prevention and Management of Severe Complications in Direct-to-Implant Breast Reconstruction.

Authors:
Zhuming Yin Huiqing Wang Yue Liu Yan Wang Edward I Chang Jian Yin

Plast Reconstr Surg 2022 Aug 10. Epub 2022 Aug 10.

Department of Breast Oncoplastic and Reconstructive Surgery, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Sino-Russian Joint Research Center for Oncoplastic Breast Surgery; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, China.

Background: Complications including infection and wound dehiscence are major concerns for direct-to-implant (DTI) breast reconstruction. However, the risk factors associated with severe complications and implant salvage remain unclear.

Methods: Retrospective study of all patients undergoing unilateral DTI breast reconstruction from 2014 through 2019. Read More

View Article and Full-Text PDF
August 2022
Similar Publications

"Closed Incision Negative Pressure Therapy (ciNPT) reduces abdominal donor site surgical wound dehiscence in Deep Internal Epigastric Perforator (DIEP) flap breast reconstructions: DEhiscence PREvention Study II (DEPRES II) - a Randomized Clinical Trial".

Authors:
Emmy Muller-Sloof Erik de Laat Onur Kenç Ali Kumaş Hester Vermeulen Stefan Hummelink Dietmar J O Ulrich

Plast Reconstr Surg 2022 Aug 10. Epub 2022 Aug 10.

Dietmar J.O. Ulrich, M.D., Ph.D. Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands, no financial disclosures.

Background: In breast reconstruction surgeries, surgical wound dehiscence is a serious complication which generates a significant burden on patients and healthcare systems. There are indications that postoperative treatment with closed incision negative pressure therapy (ciNPT) has been associated with reduced wound dehiscence rates. This randomized clinical trial examines the effect of ciNPT application on abdominal donor site surgical wound dehiscence in low- and high-risk patients undergoing a breast reconstruction with a deep internal epigastric perforator (DIEP) flap. Read More

View Article and Full-Text PDF
August 2022
Similar Publications

Impact on capsule formation for three different types of implant surface tomography.

Authors:
Hyeon Jun Jeon MyeongJae Kang Joon Seok Lee Jieun Kang Eun A Kim Hee Kyung Jin Jae-Sung Bae Jung Dug Yang

Sci Rep 2022 Aug 8;12(1):13535. Epub 2022 Aug 8.

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 700-421, Korea.

Although capsular contracture remains one of the major problems following silicone breast implantation, the associated mechanism has yet to be determined. This study thus aimed to investigate capsule formation and capsular contracture using three types of implants with different surface topographies in vivo. Three types of implants (i. Read More

View Article and Full-Text PDF
August 2022
Similar Publications

Free extended anterolateral thigh myocutaneous flap versus combined pedicled pectoralis major-latissimus dorsi myocutaneous flaps in deep and extensive sternal wound reconstruction.

Authors:
Shyun-Jing Wee Shao-Yun Hsu Pin-Keng Shih Jian-Xun Chen Chang-Cheng Chang

Microsurgery 2022 Aug 8. Epub 2022 Aug 8.

Department of Surgery, China Medical University Hospital, Taichung, Taiwan.

Background: The combined pedicled pectoralis major-latissimus dorsi (PM-LD) and free extended anterolateral thigh (ALT) myocutaneous flaps provide well-vascularized tissues for extensive sternal wound reconstruction. However, the outcomes and postoperative complications between the two surgical techniques are different. Thus, the aim of this study is to evaluate the feasibility of these two reconstructive options. Read More

View Article and Full-Text PDF
August 2022
Similar Publications

The application of photodynamic therapy in plastic and reconstructive surgery.

Authors:
Min Wu Xiaoyu Huang Lu Gao Guoyu Zhou Feng Xie

Front Chem 2022 22;10:967312. Epub 2022 Jul 22.

Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.

Photodynamic therapy (PDT) is a modern clinical treatment paradigm with the advantages of high selectivity, non-invasiveness, rare side-effect, no obvious drug resistance and easy combination with other therapies. These features have endowed PDT with high focus and application prospects. Studies of photodynamic therapy have been expanded in a lot of biomedical and clinical fields, especially Plastic and Reconstructive Surgery (PRS) the author major in. Read More

View Article and Full-Text PDF
July 2022
Similar Publications
}
© 2022 PubFacts.
  • About PubFacts
  • Privacy Policy
  • Sitemap