ArticleOTA international : the open access journal of orthopaedic trauma2021
Intraoperative monitoring of femoral head perfusion in adult femoral neck fractures.
Article in OTA international : the open access journal of orthopaedic trauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.
- Methods to predict osteonecrosis of femoral head after femoral neck fracture: a systematic review of the literature.Journal of orthopaedic surgery and research · 2023Pooled it
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo validate a novel intraoperative method of quantifying femoral head perfusion in adult patients with femoral neck fractures and to determine whether the lack of a perfusion waveform correlates with the development of osteonecrosis, nonunion, or reoperation.
designProspective cohort.
settingLevel 1 trauma center. PATIENTS/
participantsNineteen patients with 20 acute femoral neck fractures treated with hip-preserving surgical fixation. All patients underwent intraoperative quantification of femoral head perfusion.
interventionIntraoperative quantification of femoral head perfusion pressure and waveform utilizing an intracranial pressure monitor. MAIN OUTCOME MEASUREMENTS: Radiographic union, avascular necrosis, revision surgery.
resultsNineteen patients (8 male, 11 female, average age 56 ± 21 years) with 20 femoral neck fractures were enrolled. Eight fractures were stable (Garden 1-2/OTA B1.1-1.3) and 12 were unstable (Garden 3-4/OTAB2.1-3.3). A waveform was present in 12 of 20 cases. The average pressures were systolic 36.8 mm Hg, diastolic 30.8 mm Hg, pulse pressure 6.0 mm Hg. A perfusion waveform was significantly associated with advanced age (
conclusionsOur study demonstrated the feasibility of a relatively low cost, minimally invasive, technique to quantify femoral head perfusion. In our limited sample, the absence of perfusion did not correlate with our main outcomes; however, the trend toward correlation with increased fracture displacement was as expected. A larger cohort of patients will be needed to detect a significant difference between those with and without a perfusion waveform with regards to our primary outcomes. Further study is needed to delineate the role such data may play in medical decision making at the time of index surgery. LEVEL OF EVIDENCE: Prognostic Level II.
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