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Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Factors associated with the development of avascular necrosis of the femoral hea...
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Vol. 63. Issue 3.
Pages 233-238 (May - June 2019)
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Vol. 63. Issue 3.
Pages 233-238 (May - June 2019)
Original Article
DOI: 10.1016/j.recote.2018.10.002
Factors associated with the development of avascular necrosis of the femoral head after non-displaced femoral neck fracture treated with internal fixation
Factores asociados al desarrollo de necrosis avascular de cabeza femoral tras fractura del cuello femoral no desplazada tratada con fijación interna
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C.D. Novoa-Parraa,
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le_male2002@hotmail.com

Corresponding author.
, S. Pérez-Ortiza, R.E. López-Trabuccoa, J.A. Blas-Dobóna, J.L. Rodrigo-Péreza, A. Lizaur-Utrillab
a Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Dr. Peset, Valencia, Spain
b Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, Spain
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Tables (3)
Table 1. Basal patient characteristics.
Table 2. Patient comorbidities.
Table 3. Multivariate analysis for factors predictive of avascular necrosis of the femoral head (ANFH).
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Abstract
Objective

To identify the factors with influence on the development of avascular necrosis of the femoral head (ANFH) in patients with non-displaced femoral neck fractures treated with internal fixation.

Material and method

Retrospective study of cases and controls. We included non-displaced femoral neck fractures treated with internal fixation, and that presented ANFH with a postoperative follow-up of at least 2 years. The baseline variables, active comorbidities of the patients, the time for surgery and the number of screws used for osteosynthesis were recorded. Comparisons were made between the groups, those that presented ANFH and those that did not. By area under the curve, the cut-offs of age and time for surgery were located.

Results

An association between sex, active comorbidities and number of screws used and the development of ANFH was not observed. The cut-off points for age and time for surgery were ≤69 years and ≤43h, respectively. No significant correlation was observed for the cut-off time for surgery. In the multivariate analysis, age ≤69 years was a significant predictor of the development of ANFH (OR 4.6; 95% CI 1.1–17.9; P=.028).

Conclusions

The patients aged 69 years or younger were at increased risk of developing ANFH after undisplaced femoral neck fracture treated with percutaneous screws.

Keywords:
Undisplaced fracture of the femoral neck
Avascular necrosis
Screw fixation
Resumen
Objetivo

Identificar los factores con influencia sobre la aparición de necrosis avascular de cabeza femoral (NACF) en pacientes con fracturas del cuello femoral no desplazadas tratadas con fijación interna.

Material y método

Estudio retrospectivo de casos y controles. Se incluyeron las fracturas de cuello femoral no desplazada, tratadas con fijación interna, y que presentaron NACF tras un seguimiento postoperatorio de al menos 2 años. Se registraron las variables basales, las comorbilidades activas de los pacientes, así como el tiempo para la cirugía y el número de tornillos utilizados para la osteosíntesis. Se realizaron comparaciones entre los grupos, aquellos que presentaron NACF y los que no. Mediante el área bajo la curva se localizaron los puntos de corte de las variables edad y tiempo para la cirugía.

Resultados

No encontramos asociación entre el sexo, las comorbilidades activas y el número de tornillos utilizados y el desarrollo de NACF. Los puntos de corte para la edad y el tiempo para la cirugía fueron69 años y43h, respectivamente. No encontramos asociación estadísticamente significativa para el punto de corte del tiempo para la cirugía. En el análisis multivariante, la edad69 años fue un predictor significativo de desarrollo de NACF (OR 4,6; IC 95% 1,1-17,9; p=0,028).

Conclusiones

Los pacientes con una edad igual o menor de 69 años presentaban un mayor riesgo de desarrollar NACF tras fractura no desplazada del cuello femoral tratada con fijación percutánea atornillada.

Palabras clave:
Fractura no desplazada del cuello femoral
Necrosis avascular
Fijación con tornillos

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