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Clinical outcomes of patients with Garden I and II femoral neck fractures as verified on MRI: a retrospective case series
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.ORCID-id: 0000-0003-4615-7276
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.ORCID-id: 0000-0001-6062-6548
Department of Orthopaedics, Lund University, Skåne University Hospital, Malmö, Sweden.
Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden.
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2022 (Engelska)Ingår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, nr 1, artikel-id 144Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Between 2 to 10% of non-displaced femoral neck fractures (nFNF) cannot be diagnosed on plain radiographs and require further imaging investigation to be detected or verified. These fractures are referred to as occult hip fractures. This study aimed to report treatment failures, reoperations and mortality in a consecutive series of occult femoral neck fractures (FNF) treated with internal fixation (IF).

METHODS: A retrospective multicenter study was performed based on a consecutive series of patients aged ≥ 60 years with an occult magnetic resonance imaging (MRI) verified Garden I and II FNF sustained after a trauma and treated with primary IF. We included 93 patients with a minimum 2-year follow-up. Radiographic assessment encompassed pre- and postoperative tilt, implant inclination, MRI and treatment failure. Data on reoperation and mortality were collected. Treatment failure was defined as fixation failure, nonunion, avascular necrosis or posttraumatic osteoarthritis.

RESULTS: The study comprised of 93 patients (72% women, 67/93) with a mean age of 82 (range, 60-97) years. Overall, 6 (6%) patients had major reoperations. 2 (2%) had minor reoperations. One-month mortality was 7%, 1-year mortality was 20% and 2-year mortality was 31%.

CONCLUSION: This multicenter cohort study identifies a subgroup of elderly patients with MRI verified Garden I and II FNFs sustained after trauma, i.e. occult fractures. These fractures seem to have a lower complication rate compared to nFNF identified on plain radiographs.

LEVEL OF EVIDENCE: Prognostic Level V. See Instructions to Authors for a complete description of levels of evidence.

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Springer Nature, 2022. Vol. 23, nr 1, artikel-id 144
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Ortopedi
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URN: urn:nbn:se:umu:diva-192458DOI: 10.1186/s12891-022-05088-0ISI: 000754358700001PubMedID: 35151282Scopus ID: 2-s2.0-85124636621OAI: oai:DiVA.org:umu-192458DiVA, id: diva2:1637384
Tillgänglig från: 2022-02-14 Skapad: 2022-02-14 Senast uppdaterad: 2024-01-17Bibliografiskt granskad

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Sundkvist, JonasSjöholm, PontusMukka, Sebastian

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