创伤与治疗杂志

Osteonecrosis of the Femoral Head in Garden 1 Femoral Neck Fractures

Abstract

Mohamed Khalil Benhamida, Mohamed Ali Bekkay, Oussama Ben Mohamed, Youssef Mallat, Abdelhakim Kherfani and Mondher Mestiri

Introduction: Femoral neck fractures are a common public health problem and femoral head osteonecrosis represents the ultimate complication of this disease.

Methods: We conducted a retrospective study of 102 Garden 1 femoral neck fractures managed by a conservative surgical treatment. We studied the occurrence of femoral head osteonecrosis and its risk factors.

Results: The mean age was 63 years. On radiographs, Pauwels type III fractures accounted for 50% of fractures and a posterior femoral head tilt more than 10° was found in 75% of cases. The average preoperative delay was 7.18 days, 43.75% of patients were operated between the 3rd and the 7th day. Full weight bearing delay was less than 3 months in 78.12% of cases. Osteonecrosis occurred in 31.4% of cases in an average delay of 11.37 months. Risk factors with a statistically significant correlation with the occurrence of osteonecrosis were a preoperative delay between the 3rd and 7th day (p=0.006), Pauwels type III fractures (p<0.001), a femoral head tilt >10° (p<0.001) and a full weight bearing delay <3 months (p=0.02).

Conclusions: Femoral head osteonecrosis is a serious complication in undisplaced femoral neck fractures. The understanding of its occurrence risk factors is the key in avoiding it.