Nonanatomical reduction of femoral neck fractures in young patients treated with femoral neck system: a retrospective cohort study

BMC Musculoskelet Disord. 2023 May 24;24(1):412. doi: 10.1186/s12891-023-06551-2.

Abstract

Purpose: Negative buttress reduction should be avoided in the treatment of femoral neck fractures (FNFs) using conventional fixation. As the femoral neck system (FNS) has been recently developed and utilized widely to treat FNFs, the association of reduction quality with postoperative complications and clinical function has not been clarified. The purpose of this study was to evaluate the clinical effect of nonanatomical reduction in young patients with FNFs treated with FNS.

Methods: This multicenter, retrospective cohort study included 58 patients with FNFs treated with FNS between September 2019 and December 2021. According to the reduction quality immediately following surgery, patients were classified into positive, anatomical, and negative buttress reduction groups. Postoperative complications were assessed with 12 months of follow-up. The logistic regression model was used to identify risk factors for postoperative complications. The postoperative hip function was assessed using the Harris hip scores (HHS) system.

Results: At a follow-up of 12 months, a total of eight patients (8/58, 13.8%) had postoperative complications in three groups. Compared with the anatomical reduction group, negative buttress reduction was significantly associated with a higher complication rate (OR = 2.99, 95%CI 1.10-8.10, P = 0.03). No significant associations were found between positive buttress reduction and the incidence of postoperative complications (OR = 1.21, 95%CI 0.35-4.14, P = 0.76). The difference was not statistically significant in Harris hip scores.

Conclusion: Negative buttress reduction should be avoided in young patients with FNFs treated with FNS.

Keywords: Complications; FNS; Femoral neck fractures; Femoral neck system; Nonanatomical reduction.

Publication types

  • Multicenter Study

MeSH terms

  • Femoral Neck Fractures* / surgery
  • Femur Neck / injuries
  • Femur Neck / surgery
  • Fenofibrate*
  • Fracture Fixation* / adverse effects
  • Fracture Fixation* / methods
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies

Substances

  • Fenofibrate