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Topic:

Femoral Neck Fracture

Issue:

Hip

Category:

Trauma

Title:

The Duration of Hardware Retention After Radiologic Union of Surgically Treated Femoral Neck Fractures in Children May Predict the Aggravation or Occurrence of Avascular Necrosis of the Femoral Head or Neck After Hardware Removal

Author:

Wang, WenTao MD, PhD; Mei, QianQian MD; Guo, YueMing MD; He, Bo MD, PhD; Mei, HaiBo MD; Li, YiQiang MD, PhD; Canavese, Federico MD, PhD; Chen, ShunYou MD, PhD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e7-e14, DOI: 10.1097/BPO.0000000000002523

Level Of Evidence:

III

# of Patients:

71

Study Type:

Retrospective cohort study

Location:

Unknown

Summary:

This study investigates the risk factors for the aggravation or occurrence of avascular necrosis (AVN) of the femoral head or neck after hardware removal in surgically treated pediatric femoral neck fractures that had achieved radiologic union.

Methods:

Retrospective analysis of risk factors including age, sex, fracture type, time from trauma to reduction, and hardware retention time, among others. Radiographs were used to assess AVN severity using Ratliff’s classification.

Exclusions:

Not specified

Results:

Incidence of AVN: Aggravation or occurrence of AVN occurred in 15.5% of hips after hardware removal. Types of AVN: Of the 11 hips with AVN, 5 showed aggravation of pre-existing AVN, and 6 developed AVN post-removal. Risk Factor for AVN: Duration of hardware retention >7 months after radiologic union was associated with a reduced risk of aggravation or occurrence of AVN (AUC analysis).

Conclusions:

The study found that 15.5% of patients developed or had aggravated AVN following hardware removal. Retention of hardware for more than 7 months after union may reduce the likelihood of AVN complications post-surgery.

Relevance:

Limitations:

Perspective:

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