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Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures
BACKGROUND: In 2018, Femoral Neck System (FNS), a dedicated fixator for femoral neck fractures, was introduced. This device has been in increasing use because it provides excellent rotational and angular stability. However, the shortest bolt of FNS is 75 mm long. Thus, it is not usable when the axia...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Orthopaedic Association
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232318/ https://www.ncbi.nlm.nih.gov/pubmed/37274503 http://dx.doi.org/10.4055/cios21222 |
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author | Park, Jung-Wee Lee, Young-Kyun Kim, Hong Seok Kim, Jin-Kak Ha, Yong-Chan Koo, Kyung-Hoi |
author_facet | Park, Jung-Wee Lee, Young-Kyun Kim, Hong Seok Kim, Jin-Kak Ha, Yong-Chan Koo, Kyung-Hoi |
author_sort | Park, Jung-Wee |
collection | PubMed |
description | BACKGROUND: In 2018, Femoral Neck System (FNS), a dedicated fixator for femoral neck fractures, was introduced. This device has been in increasing use because it provides excellent rotational and angular stability. However, the shortest bolt of FNS is 75 mm long. Thus, it is not usable when the axial length of the proximal femur (ALPF), the distance between the innominate tubercle and the surface of the femoral head, is less than 80 mm. In this study, we investigated the incidence and associated factors of small ALPF (< 80 mm) in femoral neck fracture patients. METHODS: We measured the ALPF on preoperative computed tomography (CT) scans of 261 patients (166 women and 55 men), who were operated due to nondisplaced or impacted femoral neck fractures. The ALPF was measured on reconstructed oblique coronal images along the femoral neck. We evaluated the distribution of ALPF, calculated the incidence of small ALPF (< 80 mm), and correlated it with patient’s height, weight, body mass index, age, bone mineral density (T-score), and caput-column-diaphysis angle. RESULTS: The ALPF ranged from 67.4 mm to 107.1 mm (mean, 88.4 mm; standard deviation, 7.2 mm). In 19 patients (8.6%, 19 / 221), the length was < 80 mm. The ALPF was strongly correlated with height (correlation coefficient = 0.707, R(2) = 0.500, p < 0.001) and moderately correlated with weight (correlation coefficient = 0.551, R(2) = 0.304, p < 0.001). The T-score was moderately correlated with the ALPF (correlation coefficient = 0.433, R(2) = 0.187, p < 0.001). The age was moderately correlated with the ALPF (correlation coefficient =–0.353, R(2) = 0.123, p < 0.001). CONCLUSIONS: A considerable percentage of femoral neck fracture patients (8.6%) had small proximal femurs (ALPF < 80 mm), which cannot be operated with FNS. We recommend measuring the ALPF using reconstructed oblique coronal CT images or scaled hip radiographs: en face view of the femoral neck prior to surgery in patients with short stature and/or low body weight. If the ALPF is < 80 mm, the surgeon should prepare other fixation devices. |
format | Online Article Text |
id | pubmed-10232318 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-102323182023-06-02 Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures Park, Jung-Wee Lee, Young-Kyun Kim, Hong Seok Kim, Jin-Kak Ha, Yong-Chan Koo, Kyung-Hoi Clin Orthop Surg Original Article BACKGROUND: In 2018, Femoral Neck System (FNS), a dedicated fixator for femoral neck fractures, was introduced. This device has been in increasing use because it provides excellent rotational and angular stability. However, the shortest bolt of FNS is 75 mm long. Thus, it is not usable when the axial length of the proximal femur (ALPF), the distance between the innominate tubercle and the surface of the femoral head, is less than 80 mm. In this study, we investigated the incidence and associated factors of small ALPF (< 80 mm) in femoral neck fracture patients. METHODS: We measured the ALPF on preoperative computed tomography (CT) scans of 261 patients (166 women and 55 men), who were operated due to nondisplaced or impacted femoral neck fractures. The ALPF was measured on reconstructed oblique coronal images along the femoral neck. We evaluated the distribution of ALPF, calculated the incidence of small ALPF (< 80 mm), and correlated it with patient’s height, weight, body mass index, age, bone mineral density (T-score), and caput-column-diaphysis angle. RESULTS: The ALPF ranged from 67.4 mm to 107.1 mm (mean, 88.4 mm; standard deviation, 7.2 mm). In 19 patients (8.6%, 19 / 221), the length was < 80 mm. The ALPF was strongly correlated with height (correlation coefficient = 0.707, R(2) = 0.500, p < 0.001) and moderately correlated with weight (correlation coefficient = 0.551, R(2) = 0.304, p < 0.001). The T-score was moderately correlated with the ALPF (correlation coefficient = 0.433, R(2) = 0.187, p < 0.001). The age was moderately correlated with the ALPF (correlation coefficient =–0.353, R(2) = 0.123, p < 0.001). CONCLUSIONS: A considerable percentage of femoral neck fracture patients (8.6%) had small proximal femurs (ALPF < 80 mm), which cannot be operated with FNS. We recommend measuring the ALPF using reconstructed oblique coronal CT images or scaled hip radiographs: en face view of the femoral neck prior to surgery in patients with short stature and/or low body weight. If the ALPF is < 80 mm, the surgeon should prepare other fixation devices. The Korean Orthopaedic Association 2023-06 2023-01-25 /pmc/articles/PMC10232318/ /pubmed/37274503 http://dx.doi.org/10.4055/cios21222 Text en Copyright © 2023 by The Korean Orthopaedic Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Park, Jung-Wee Lee, Young-Kyun Kim, Hong Seok Kim, Jin-Kak Ha, Yong-Chan Koo, Kyung-Hoi Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title | Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title_full | Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title_fullStr | Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title_full_unstemmed | Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title_short | Incidence and Risk Factors of Short Axial Length of the Proximal Femur: A Caution in the Use of Femoral Neck System in Patients with Garden Type I/II Femoral Neck Fractures |
title_sort | incidence and risk factors of short axial length of the proximal femur: a caution in the use of femoral neck system in patients with garden type i/ii femoral neck fractures |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232318/ https://www.ncbi.nlm.nih.gov/pubmed/37274503 http://dx.doi.org/10.4055/cios21222 |
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