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

作者全名："Wang, WenTao; Mei, QianQian; Guo, YueMing; He, Bo; Mei, HaiBo; Li, YiQiang; Canavese, Federico; Chen, ShunYou"

作者地址："[Wang, WenTao] Sun Yat Sen Univ, Affiliated Hosp 7, Sci Res Ctr, Shenzhen, Peoples R China; [Mei, QianQian] ShenZhen Childrens Hosp, Dept Pediat Orthoped, Shenzhen, Peoples R China; [Guo, YueMing] Foshan Hosp Tradit Chinese Med, Dept Orthopaed, Foshan, Peoples R China; [He, Bo] Chongqing Med Univ, Childrens Hosp, Dept Pediat Orthopaed, Chongqing, Peoples R China; [Mei, HaiBo] Hunan Childrens Hosp, Dept Pediat Orthoped, Changsha, Hunan, Peoples R China; [Li, YiQiang] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Pediat Orthopaed, Guangzhou, Peoples R China; [Chen, ShunYou] FuZhou Second Hosp, Dept Pediat Orthopaed, 47th ShangTeng Rd CangShan Dist, Fuzhou 350007, Fujian, Peoples R China; [Canavese, Federico] Lille Univ Ctr, Jeanne de Flandre Hosp, Dept Pediat Orthopaed, Lille, France"

通信作者："Chen, SY (通讯作者)，FuZhou Second Hosp, Dept Pediat Orthopaed, 47th ShangTeng Rd CangShan Dist, Fuzhou 350007, Fujian, Peoples R China."

来源：JOURNAL OF PEDIATRIC ORTHOPAEDICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001122971900010

JCR分区：Q2

影响因子：1.7

年份：2024

卷号：44

期号：1

开始页：E7

结束页：E14

文献类型：Article

关键词：children; femoral neck fracture; avascular necrosis; hardware removal; femoral neck; femoral head

摘要："Background: The incidence of aggravation or occurrence of avascular necrosis (AVN) following hardware removal in surgically treated pediatric femoral neck fractures who achieved radiologic consolidation is unknown. This study aimed to investigate the risk factors for this complication.Methods: Seventy-one pediatric (mean age: 9.8 +/- 3.9 y) were retrospectively analyzed. Risk factors (age, sex, laterality, severity of initial displacement, type of fracture, time from trauma to reduction, reduction and fixation method, quality of reduction, time required to achieve radiologic union, duration of hardware retention, presence of AVN before hardware removal and follow-up time) were recorded. The severity of AVN was assessed based on radiographs with Ratliff's classification.Results: Following hardware removal, the aggravation/occurrence of AVN was detected in 11 hips (15.5%). Among the 5 hips (7%) with aggravation of AVN, 1 (1.4%) with type II AVN and 3 (4.2%) with type III AVN exhibited aggravation of type I AVN, while the remaining hip (1.4%; type I) showed enlargement of the involved AVN area. Six hips (8.5%) developed AVN following hardware removal: 2 (2.8%) were classified as type I and 4 (5.6%) as type III. Receiver operating characteristic curve analysis indicated that hardware retention >7 months after union is associated with a decreased rate of aggravation or occurrence of AVN of the femoral neck or head following hardware removal.Conclusions: The incidence of aggravation or occurrence of AVN following hardware removal in surgically treated pediatric femoral neck fractures is 15.5%; hardware retention >7 months after radiologic union may reduce the risk of aggravation or occurrence of AVN of the femoral neck or head postimplant removal."

基金机构：Sanming Project of Medicine in Shenzhen [SZSM 202011012]; Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma [2020Y2014]

基金资助正文：This study is supported by Sanming Project of Medicine in Shenzhen(SZSM 202011012) and Fujian Provincial Clinical Medical ResearchCenter for First Aid and Rehabilitation in Orthopaedic Trauma(2020Y2014).