ArticleJB & JS open access
Preoperative Anterior and Posterior Tilt of Garden I-II Femoral Neck Fractures Predict Treatment Failure and Need for Reoperation in Patients Over 60 Years.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Targeted Fully-Threaded Screw Augmentation with the Femoral Neck System Reduces Neck Shortening and Posterior Tilt, Leading to Improved Function in Geriatric Garden I-II Femoral Neck Fractures: A Retrospective Comparative Study.Clinics in orthopedic surgery · 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
- Femoral Neck Fracture With Anterior Tilt.Orthopaedic surgery · 2026Article
- An Acta Orthopaedica educational article: Femoral neck fractures in adults with emphasis on surgical treatment.Acta orthopaedica · 2025Review
- When would orthopaedic surgeons perform arthroplasty for a femoral neck fracture in an older adult?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Basicervical femoral neck fractures: an observational study derived from the Swedish Fracture Register.Acta orthopaedica · 2024Observational
- Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty.Orthopedic research and reviews · 2024Review
- 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
- Validation of direct CT measurement of malrotation in femoral neck fractures: A bone model study.PloS one · 2023Article
- Internal Fixation of Garden Type III Femoral Neck Fractures with Sliding Hip Screw and Anti-Rotation Screw: Does Increased Valgus Improve Healing?Medicina (Kaunas, Lithuania) · 2022Article
- Clinical outcomes of patients with Garden I and II femoral neck fractures as verified on MRI: a retrospective case series.BMC musculoskeletal disorders · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of the present study was to estimate the effect of preoperative fracture tilt and to scrutinize the effect of anterior tilt on the risk of treatment failure in patients with Garden Type-I and II femoral neck fractures that are treated with internal fixation.
methodsA retrospective multicenter study was performed on a consecutive series of patients ≥60 years of age who had undergone primary internal fixation for the treatment of Garden Type-I and II femoral neck fractures. The study included 1,505 patients with a minimum follow-up of 2 years. Radiographic assessments encompassed preoperative and postoperative tilt, implant inclination, and treatment failure. Data on reoperation and mortality were collected. The risk of treatment failure was assessed with use of Cox proportional hazard regression analysis.
resultsThe study comprised 1,505 patients (71% female) with a median age of 81 years (range, 60 to 108 years). Overall, 234 patients (16%) were classified as having a treatment failure and 251 patients (17%) underwent reoperation. A preoperative anterior tilt of >10° and a posterior tilt of >20° were predictors of treatment failure and reoperation, respectively. Treatment failure occurred in 74 (25%) of 301 patients with a posterior tilt of >20° and in 17 (43%) of 40 patients with an anterior tilt of >10°.
conclusionsThis multicenter cohort study identified a subgroup of patients with Garden Type-I and II femoral neck fractures with an anterior tilt of >10° as having high treatment failure rates and major reoperation rates comparable with those associated with displaced femoral neck fractures. A preoperative posterior tilt of >20° increases the risk of treatment failure, and the potential benefit of arthroplasty in this subgroup of patients remains to be further investigated. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions to Authors for a complete description of levels of evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.