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

被引：1

作者：

Mei, Jiong ^{[1
]}

Wang, Shuqing ^{[2
]}

Ni, Ming ^{[3
,4
]}

Zhang, Fangfang ^{[2
]}

Tang, Jianfei ^{[1
]}

Bi, Gang ^{[2
]}

Zhu, Yi ^{[1
]}

Zhu, Xiaozhong ^{[2
]}

Lu, Ye ^{[1
]}

机构：

[1] Shanghai Jiao Tong Univ, Dept Orthoped Surg, Affiliated Peoples Hosp 6, Shanghai 200233, Peoples R China

[2] Tongji Univ, Tongji Hosp, Dept Orthopaed, Sch Med, Shanghai, Peoples R China

[3] Shanghai Jiao Tong Univ Sch Med, Ruijin Hosp, Dept Sci Dev, Shanghai, Peoples R China

[4] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Sci Dev, Shanghai, Peoples R China

来源：

ORTHOPAEDIC SURGERY | 2022年 / 14卷 / 08期

基金：

中国国家自然科学基金;

关键词：

Closed reduction; Femoral head necrosis; Osteonecrosis; Femoral neck fracture; Retinaculum of Weitbrecht; MANAGEMENT; FEMUR;

D O I：

10.1111/os.13378

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

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.

引用

页码：1759 / 1767

页数：9