Femoral Neck Shortening After Hip Fracture Fixation Is Associated With Inferior Hip Function: Results From the FAITH Trial

被引：86

作者：

Felton, Jessica ^{[1
]}

Slobogean, Gerard P. ^{[2
,22
]}

Jackson, Sarah S. ^{[3
]}

Della Rocca, Gregory J. ^{[4
,21
,64
]}

Liew, Susan ^{[5
,15
]}

Haverlag, Robert ^{[6
,73
,81
]}

Jeray, Kyle J. ^{[7
,14
]}

Sprague, Sheila A. ^{[8
,9
]}

O'Hara, Nathan N. ^{[2
]}

Swiontkowski, Marc ^{[10
,12
]}

Bhandari, Mohit ^{[8
,9
,11
]}

Devereaux, P. J. ^{[11
]}

Guyatt, Gordon ^{[11
]}

Heetveld, Martin J. ^{[13
,19
,70
]}

Jeray, Kyle ^{[14
]}

Richardson, Martin ^{[16
]}

Schemitsch, Emil H. ^{[17
,27
]}

Thabane, Lehana ^{[11
]}

Tornetta, Paul, III ^{[18
,51
]}

Walter, Stephen D. ^{[11
]}

Sprague, Sheila ^{[11
]}

McKay, Paula ^{[11
]}

Scott, Taryn ^{[11
]}

Garibaldi, Alisha ^{[11
]}

Viveiros, Helena ^{[11
]}

Swinton, Marilyn ^{[11
]}

Gichuru, Mark ^{[11
]}

Bzovsky, Sofia ^{[11
]}

Heels-Ansdell, Diane ^{[11
]}

Zhou, Qi ^{[11
]}

Buckingham, Lisa ^{[11
]}

Duraikannan, Aravin ^{[11
]}

Maddock, Deborah ^{[11
]}

Simunovic, Nicole ^{[11
,31
]}

Agel, Julie ^{[12
]}

Van Lieshout, Esther M. M. ^{[19
]}

Zielinski, Stephanie M. ^{[19
]}

Rangan, Amar ^{[20
]}

Hanusch, Birgit C. ^{[20
]}

Kottam, Lucksy ^{[20
]}

Clarkson, Rachel ^{[20
]}

McCormack, Robert ^{[23
]}

Apostle, Kelly ^{[23
]}

Boyer, Dory ^{[23
]}

Moola, Farhad ^{[23
]}

Perey, Bertrand ^{[23
]}

Stone, Trevor ^{[23
]}

Viskontas, Darius ^{[23
]}

Lemke, H. Michael ^{[23
]}

Zomar, Mauri ^{[23
]}

机构：

[1] Univ Maryland, Dept Surg, Sch Med, Baltimore, MD 21201 USA

[2] Univ Maryland, R Adams Cowley Shock Trauma Ctr, Dept Orthopaed, Sch Med, Baltimore, MD 21201 USA

[3] Univ Maryland, Dept Epidemiol & Publ Hlth, Sch Med, Baltimore, MD 21201 USA

[4] Duke Univ, Dept Orthopaed Surg, Durham, NC USA

[5] The Alfred, Dept Orthopaed Surg, Melbourne, Vic, Australia

[6] Onze Lieve Vrouw Hosp, Dept Gen & Trauma Surg, Amsterdam, Netherlands

[7] Greenville Hlth Syst, Dept Orthopaed Surg, Greenville, SC USA

[8] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[9] McMaster Univ, Dept Surg, Div Orthopaed Surg, Hamilton, ON, Canada

[10] Univ Minnesota, Dept Orthopaed Surg, Minneapolis, MN 55455 USA

[11] McMaster Univ, Hamilton, ON, Canada

[12] Univ Minnesota, Minneapolis, MN 55455 USA

[13] Spaarne Gasthuis, Haarlem, Netherlands

[14] Greenville Hlth Syst, Greenville, SC USA

[15] The Alfred, Melbourne, Vic, Australia

[16] Univ Melbourne, Melbourne, Vic, Australia

[17] Univ Western Ontario, London, ON, Canada

[18] Boston Univ, Med Ctr, Boston, MA 02115 USA

[19] Univ Med Ctr Rotterdam, Erasmus MC, Rotterdam, Netherlands

[20] James Cook Univ Hosp, Middlesbrough, Cleveland, England

[21] Duke Univ, Durham, NC 27706 USA

[22] Univ Maryland, Baltimore, MD 21201 USA

[23] Univ British Columbia, Royal Columbian Hosp, Fraser Hlth Author, Vancouver, BC, Canada

[24] Foothills Med Ctr, Calgary, AB, Canada

[25] London Hlth Sci Ctr, London, ON, Canada

[26] Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[27] St Michaels Hosp, Toronto, ON, Canada

[28] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[29] Queens Univ, Human Mobil Res Ctr, Kingston, ON, Canada

[30] Kingston Gen Hosp, Kingston, ON, Canada

[31] Oakville Trafalgar Mem Hosp, Oakville, ON, Canada

[32] Ottawa Hosp, Ottawa, ON, Canada

[33] Juravinski Hosp & Canc Ctr, Hamilton, ON, Canada

[34] Boone Hosp Ctr, Columbia Orthopaed Grp, Columbia, MO USA

[35] Orthopaed Associates Michigan, Grand Rapids, MI USA

[36] Reg Hosp Univ Minnesota, Minneapolis, MN USA

[37] Lahey Hosp & Med Ctr, Burlington, MA USA

[38] MetroHlth Med Ctr, Cleveland, OH USA

[39] Miami Valley Hosp, Dayton, OH USA

[40] St Elizabeth Youngstown Hosp, Youngstown, OH USA

[41] Univ Rochester, Med Ctr, Rochester, NY 14627 USA

[42] Colorado Orthoped Consultants, Aurora, CO USA

[43] St Louis Univ Hosp, St Louis, MO USA

[44] Univ Penn, Philadelphia, PA 19104 USA

[45] Northwest Orthopaed Specialists, Spokane, WA USA

[46] Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA

[47] Mayo Clin, Rochester, MN USA

[48] Texas Tech Univ, Hlth Sci Ctr Lubbock, Lubbock, TX 79409 USA

[49] Univ Orthopaed Associates LLC, Somerset, NJ USA

[50] US Army, Inst Surg Res, Jbsa Ft Sam Houston, TX USA

来源：

JOURNAL OF ORTHOPAEDIC TRAUMA | 2019年 / 33卷 / 10期

基金：

美国国家卫生研究院; 加拿大健康研究院;

关键词：

femoral neck fracture; internal fixation; femoral neck shortening; WOMAC; FAITH; hip function; INTERNAL-FIXATION; VARUS COLLAPSE; MULTICENTER; SCREWS;

D O I：

10.1097/BOT.0000000000001551

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 describe the distribution of femoral neck shortening after internal fixation and to determine whether shortening is associated with inferior hip function at 24 months after a hip fracture in patients 50 years of age or older. Design: Retrospective cohort study. Setting: A secondary analysis of data from 81 clinical centers included in the Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH) trial. Participants: Three hundred fifty patients, 50 years of age or older, who had an isolated femoral neck fracture and underwent timely operative fixation of the fracture. Intervention: Femoral neck shortening was measured as a categorical variable and classified into one of the following groups, as determined by the Central Adjudication Committee: no shortening, mild shortening (<= 5 mm), moderate shortening (6-10 mm), or severe shortening (>10 mm). Main Outcome Measurement: The primary outcome for the current analysis was hip function, as measured by the Western Ontario & McMaster Universities Osteoarthritis Index questionnaire, at 24 months after injury. Results: Two-thirds of patients had no or mild shortening (<= 5 mm), whereas one-third of patients had moderate or severe shortening (>5 mm). After adjusting for surgical treatment, a greater amount of femoral neck shortening was found to be associated with poorer hip function (P < 0.01). Conclusions: We found that increasing femoral neck shortening was associated with inferior hip function. Although internal fixation often results in successful union, patients who heal in a shortened position report poorer functional outcomes.

引用

页码：487 / 496

页数：10

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