Artikel
Results and functional outcome of femoral neck non-unions in young adults
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Autoren
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M. Coulibaly
- BG Universitätsklinik Bergmannsheil GmbH, Chirurgische Universitäts- und Poliklinik, Ruhr-Universität Bochum, Bochum, Germany
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D. Sietsema
- Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, USA
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T.A. Schildhauer
- BG Universitätsklinik Bergmannsheil GmbH, Chirurgische Universitäts- und Poliklinik, Ruhr-Universität Bochum, Bochum, Germany
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C. Jones
- Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, USA
| Veröffentlicht: | 18. Oktober 2011 |
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Gliederung
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Questionnaire: Femoral neck non-unions (FNNU) are common complications after internal fixation of femoral neck fractures in young adults. The purpose of this study was to evaluate results and long-term functional outcome.
Methods: A retrospective analysis was undertaken on a cohort of 28 patients diagnosed with FNNU between March 2002 and Dec 2007 at a Level I teaching trauma center. Outcomes were results (pain, assistive devices, shoe wear, and level of activity) and prospective assessment of functional status (Short Musculoskeletal Form Assessment [SMFA] and Short Form 36 [SF-36]).
Results and conclusions: 22 patients met inclusion criteria. 14 males and 8 females had a mean age of 44.1 (19-65) and BMI of 26.2 (18-41). Mechanism of injury was low-energy falls (12/22, 54.5%) and high-energy injuries (10/22, 45.5%). AO/OTA fracture classification included 9/22 (40.9%) B2 and 13 B3 fracture pattern. Fracture treatment consisted of 17/22 (77.3%) ORIF and 5/22 (22.7%) CRIF and secondary surgery for FNNU was 10 intertrochanteric osteotomies and 8 arthroplasties. Complications included leg length shortening (17/22, 77.3%), secondary OA (9, 40.9%), heterotopic ossification (8 Brooker I, 3 Brooker II), AVN (7/22, 31.8%), and infection (1/22, 4.5%). Functional status indices are outlined in Table 1 [Tab. 1]. Pain requiring medication was present in 14 cases (63.4%). Mobility assistive devices were utilized in 4 patients and 14 patients were limping. Specialized shoe wear was needed by 5/20 (22.7%). Return to work status was 14/22 (63.6%) full return, six with restrictions, and 2 did not return to previous level of activity. BMI independently contributed to inferior functional status (DYSF R2=0.348, BOTH R2=0.356, PCS R2=0.445) with significance at p<0.05. FNNU functional status was significantly reduced compared to normative values (t-test, p<0.05). Femoral neck non-unions in the younger adults are debilitating injuries. Long-term functional status remains reduced. BMI contributes to inferior functional status.
