ArticleJournal of orthopaedic surgery and research2021
Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Performance of prediction models for delayed union and nonunion after fracture: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Comparison of percutaneous compression plate to parallel screws in the treatment of nondisplaced femoral neck fractures in elderly patients: a prospective, randomized study.Archives of orthopaedic and trauma surgery · 2023Trial
- Patients With Femoral Neck Fractures Are at Risk for Conversion to Arthroplasty After Internal Fixation: A Machine-learning Algorithm.Clinical orthopaedics and related research · 2022Trial
- A nomogram for assessing the risk of deep vein thrombosis following surgery for pilon fractures.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Outcomes of cannulated screw fixation for nondisplaced femoral neck fractures in patients older than 80 years: a retrospective cohort study.Journal of orthopaedic surgery and research · 2026Article
- Predictive factors for delayed union in liquid nitrogen-treated autografts following tumor resection: a retrospective study.BMC cancer · 2025Article
- Development and validation of a nomogram for predicting the risk of postoperative fracture blister after pilon fracture.Frontiers in surgery · 2024Article
- The association between three-dimensional measurement of posterior tilt angle in impacted femoral neck fractures and osteonecrosis of the femoral head.BMC musculoskeletal disorders · 2023Article
- Development and validation of a predictive nomogram for preoperative deep vein thrombosis (DVT) in isolated calcaneal fracture.Scientific reports · 2022Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveWe aimed to evaluate risk factors and develop a nomogram for reoperation after internal fixation of nondisplaced femoral neck fractures (FNFs) in elderly patients.
methodsWe conducted a retrospective study involving a total of 255 elderly patients who underwent closed reduction and internal fixation with cannulated screw system for nondisplaced FNFs between January 2016 and January 2019. We collected data on demographics, preoperative radiological parameters, surgery, serum biochemical markers, and postoperative rehabilitation. In addition, we performed univariate and multivariate logistic regression analyses to determine independent risk factors for reoperation, and then developed a nomogram to assess the risks of reoperation. Besides, discriminative ability, calibration, and clinical usefulness of the nomogram were evaluated using the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. We employed bootstrap method to validate the performance of the developed nomogram.
resultsOur analysis showed that among the 255 patients, 28 (11.0%) underwent reoperation due to osteonecrosis of the femoral head (14 cases), mechanical failure (8 cases) or nonunion (6 cases). All of the 28 patients underwent conversion surgery to arthroplasty. The multivariate logistic regression analysis demonstrated that preoperative posterior tilt angle ≥ 20°, Pauwel's III type, younger patients, preoperative elevated levels of alkaline phosphatase (ALP), preoperative hypoalbuminemia, and early postoperative weight-bearing were independent risk factors for reoperation. In addition, the C-index and the bootstrap value of the developed nomogram was 0.850 (95% CI = 0.803-0.913) and 0.811, respectively. Besides, the calibration curve showed good consistency between the actual diagnosed reoperation and the predicted probability, while the DCA indicated that the nomogram was clinically valuable.
conclusionsOur analysis showed we successfully developed and validated a nomogram for personalized prediction of reoperation after internal fixation of nondisplaced FNFs in elderly patients. This model would help in individualized evaluation of the need for reoperation and inform strategies aimed at eliminating the need for the reoperation.
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