J Korean Hip Soc.  2009 Mar;21(1):35-40. 10.5371/jkhs.2009.21.1.35.

Risk Factors for Avascular Necrosis and Nonunion after Multiple Pinning for an Intracapsular Femoral Neck Fracture

• Sung YB
• Shin YW
• Park CK

• KMID: 2190804
• DOI: http://doi.org/10.5371/jkhs.2009.21.1.35

Abstract

PURPOSE: We wanted to analyze the influences of risk factors on avascular necrosis and nonunion after multiple pinning for a femoral neck fracture.
MATERIALS AND METHODS
Among the cases of multiple pinning for a femoral neck fracture that were seen at our department from June 1995 to May 2006, we analyze 102 cases that had more than 2 years of follow-up. We evaluated the influence of such factors as the age, gender, injury on the right- or left-side, the degree of displacement, the time to operation, the angle of fracture, the accuracy of reduction and posterior cortex comminution on avascular necrosis and nonunion after multiple pinning for a femoral neck fracture.
RESULTS
The incidences of AVN and nonunion were 13.7% (14/102) and 10.7% (11/102), respectively. The degree of displacement was a significant factor that influenced the development of nonunion (p<0.05). The time to operation and the angle of fracture were significant factors that influenced nonunion (p<0.05 & p<0.05) and avascular necrosis (p<0.05 & p<0.05). The posterior cortex comminution was a significant factor that influenced nonunion (p<0.05) and avascular necrosis (p<0.05).
CONCLUSION
The important risk factor for avascular necrosis was the angle of fracture over 60 degrees. The important risk factors for nonunion were the time to operation (over 24 hours), posterior cortex comminution and an angle of fracture over 60 degrees.

Keyword

Femoral neck fracture; Multiple pinning; Avascular necrosis; Nonunion; Risk factors

MeSH Terms

Displacement (Psychology)
Femoral Neck Fractures
Femur Neck
Follow-Up Studies
Incidence
Necrosis
Risk Factors