Factors Influencing the Outcome of Osteosynthesis in the Fracture of the Femoral Neck in Young Adult Patients

Ramallo, Daniel Alves; Kropf, Leandro Lemgruber; Zaluski, Alexandre Dreifus; Cavalcanti, Amanda dos Santos; Duarte, Maria Eugenia Leite; Guimarães, João Antonio Matheus

doi:10.1016/j.rbo.2017.12.021

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Sumário

Original Article • Rev. bras. ortop. 54 (04) • Jul-Aug 2019 • https://doi.org/10.1016/j.rbo.2017.12.021 copy

Factors Influencing the Outcome of Osteosynthesis in the Fracture of the Femoral Neck in Young Adult Patients^* * Work performed at the Centro de Atenção Especializada de Trauma (CAE Trauma), Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brazil .Originally Published by Elsevier Editora Ltda.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives

To evaluate the factors that influence the outcome of osteosynthesis after closed reduction of the fracture of the femoral neck in young adult patients.

Methods

A retrospective study was conducted, reviewing the data of patients operated in a large orthopedic hospital from 2003 to 2011; a total of 81 patients met the inclusion criteria. The time interval between the fracture and the surgery, the initial fracture deviation, the quality of the reduction, and the placement of the implant were evaluated.

Results

The present study observed a strong relationship between the quality of the reduction and therapeutic success. The degree of the initial deviation and the time elapsed between the initial trauma and the osteosynthesis did not influence the surgical outcome regarding bone consolidation. The correct positioning of the implants was associated with a satisfactory evolution in the postoperative period.

Conclusion

The quality of the reduction and the positioning of the implants are factors that influence the results of osteosynthesis in fractures of the femoral neck in young adult patients.

Keywords:
femoral neck; femoral head necrosis; femoral neck fractures; pseudoarthrosis

Variable	Category	Consolidation(n= 67)		Failure (n= 14)		p-value ^a Fisher exact test.
Variable	Category	n	%	n	%	p-value ^a Fisher exact test.
Gender	Male			10	71,4	1.000
	Female	22	32.8	4	28.6
Diabetes mellitus	Yes	4	6.0	0	0	1.000
	No	63	94.0	14	100
ASA^b Documentation failure in 15 patients from the Consolidation group (n= 52), and in 2 patients from the Failure group (n= 12).	I	28	53.8	6	50.0	1.000
	II and III	24	46.1	6	50.0
Smoker	Yes	16	23.9	5	35.7	0.502
	No	51	76.1	9	64.3

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E-mail: rbo@sbot.org.br

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[1] Address for correspondence
João Antonio Matheus Guimarães, MD, PhD, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Av. Brasil, 500, Caju, Rio de Janeiro, RJ, 20940-070, Brazil (e-mail: jmatheusguimaraes@gmail.com).