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Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures

OBJECTIVE: To investigate associations between femoral head necrosis (FHN) and injury to the retinaculum of Weitbrecht in patients with femoral neck fractures who had undergone initial trials of either closed reduction or direct open reduction. METHODS: This prospective observational study included...

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Autores principales: Mei, Jiong, Wang, Shuqing, Ni, Ming, Zhang, Fangfang, Tang, Jianfei, Bi, Gang, Zhu, Yi, Zhu, Xiaozhong, Lu, Ye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363731/
https://www.ncbi.nlm.nih.gov/pubmed/35818320
http://dx.doi.org/10.1111/os.13378
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author Mei, Jiong
Wang, Shuqing
Ni, Ming
Zhang, Fangfang
Tang, Jianfei
Bi, Gang
Zhu, Yi
Zhu, Xiaozhong
Lu, Ye
author_facet Mei, Jiong
Wang, Shuqing
Ni, Ming
Zhang, Fangfang
Tang, Jianfei
Bi, Gang
Zhu, Yi
Zhu, Xiaozhong
Lu, Ye
author_sort Mei, Jiong
collection PubMed
description OBJECTIVE: To investigate associations between femoral head necrosis (FHN) and injury to the retinaculum of Weitbrecht in patients with femoral neck fractures who had undergone initial trials of either closed reduction or direct open reduction. METHODS: This prospective observational study included 110 patients with displaced femoral neck fractures admitted to the Sixth People's Hospital Affiliated to Shanghai Jiaotong University and Shanghai Tongji Hospital between January 2008 and May 2017. Among these, 25 patients underwent initial closed reductions, and 85 patients underwent an open reduction directly. Watson‐Jones anterolateral approach was used during the surgery for injury to the retinaculum of Weitbrecht, and FHN was assessed as a surgical outcome. The severity of injury to the retinaculum of Weitbrecht was evaluated using a scoring system developed by our surgical team. Follow‐up was at least 24 months. RESULTS: The initial closed reduction treatment group had significantly higher total scores of injury to the retinaculum of Weitbrecht (6.24 ± 2.20 vs 4.62 ± 2.12, p = 0.009) compared to the open reduction group. High total scores were significantly associated with initial trials of closed reduction treatment, especially for the broken and released injury to the superior and anterior retinacula (both p = 0.01). Twenty‐six patients experienced FHN postoperatively, with mean onset time of 19.42 ± 3.87 months. FHN was significantly associated with the severity of injury to the retinaculum of Weitbrecht (p < 0.001) at the superior, anterior, and inferior retinacula. FHN was significantly associated with injury to the retinaculum of Weitbrecht in females. CONCLUSIONS: Femoral neck displacement in patients treated initially with closed reduction is associated with subsequent injury to the retinaculum of Weibrecht, which may lead to FHN. Severity of injury to the retinaculum of Weibrecht may be used as a biomarker to evaluate bone necrosis in patients with femoral neck fractures.
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spelling pubmed-93637312022-08-10 Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures Mei, Jiong Wang, Shuqing Ni, Ming Zhang, Fangfang Tang, Jianfei Bi, Gang Zhu, Yi Zhu, Xiaozhong Lu, Ye Orthop Surg Clinical Articles OBJECTIVE: To investigate associations between femoral head necrosis (FHN) and injury to the retinaculum of Weitbrecht in patients with femoral neck fractures who had undergone initial trials of either closed reduction or direct open reduction. METHODS: This prospective observational study included 110 patients with displaced femoral neck fractures admitted to the Sixth People's Hospital Affiliated to Shanghai Jiaotong University and Shanghai Tongji Hospital between January 2008 and May 2017. Among these, 25 patients underwent initial closed reductions, and 85 patients underwent an open reduction directly. Watson‐Jones anterolateral approach was used during the surgery for injury to the retinaculum of Weitbrecht, and FHN was assessed as a surgical outcome. The severity of injury to the retinaculum of Weitbrecht was evaluated using a scoring system developed by our surgical team. Follow‐up was at least 24 months. RESULTS: The initial closed reduction treatment group had significantly higher total scores of injury to the retinaculum of Weitbrecht (6.24 ± 2.20 vs 4.62 ± 2.12, p = 0.009) compared to the open reduction group. High total scores were significantly associated with initial trials of closed reduction treatment, especially for the broken and released injury to the superior and anterior retinacula (both p = 0.01). Twenty‐six patients experienced FHN postoperatively, with mean onset time of 19.42 ± 3.87 months. FHN was significantly associated with the severity of injury to the retinaculum of Weitbrecht (p < 0.001) at the superior, anterior, and inferior retinacula. FHN was significantly associated with injury to the retinaculum of Weitbrecht in females. CONCLUSIONS: Femoral neck displacement in patients treated initially with closed reduction is associated with subsequent injury to the retinaculum of Weibrecht, which may lead to FHN. Severity of injury to the retinaculum of Weibrecht may be used as a biomarker to evaluate bone necrosis in patients with femoral neck fractures. John Wiley & Sons Australia, Ltd 2022-07-11 /pmc/articles/PMC9363731/ /pubmed/35818320 http://dx.doi.org/10.1111/os.13378 Text en © 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Articles
Mei, Jiong
Wang, Shuqing
Ni, Ming
Zhang, Fangfang
Tang, Jianfei
Bi, Gang
Zhu, Yi
Zhu, Xiaozhong
Lu, Ye
Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title_full Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title_fullStr Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title_full_unstemmed Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title_short Association between Weitbrecht's Retinaculum Injury and Femoral Head Necrosis in Femoral Neck Fractures
title_sort association between weitbrecht's retinaculum injury and femoral head necrosis in femoral neck fractures
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363731/
https://www.ncbi.nlm.nih.gov/pubmed/35818320
http://dx.doi.org/10.1111/os.13378
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