Predicting the healing of the displaced subcapital hip fracture via postoperative roentgenographic factors.
Postoperative roentgenograms of displaced subcapital hip fractures treated with a sliding, keyless compression screw were analyzed for the degree of osteoporosis, level of fracture, and adequacy of reduction. Reduction was graded by measuring the AP Garden angle, the lateral Garden angle, and displacement of the femoral head with comparison to the contralateral hip. Seventy-three displaced subcapital hip fractures were treated over a four-year period. On follow-up, 52 hips were available for analysis. Follow-up examination revealed that 28 hips had failed; these were converted to total hip arthroplasties, bipolar devices, or Girdlestones. Twenty-three hips had healed at a follow-up of 23.6 months. A 24th had become infected and was converted to a Girdlestone. A review of the postoperative roentgenograms revealed that the AP Garden angle was most successful in predicting healing. The lateral Garden angle and displacement of the femoral head on the AP and lateral roentgenograms were less successful predictors. The level of the fracture, the Singh index, and demographic factors, such as age and sex, were not found to be predictive or significant.
Unger
A S
AS
Comprehensive Arthritis Program, Hospital for Special Surgery, New York City.
Shuster
H F
HF
D000368:Aged; D001863:Bone Screws; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011379:Prognosis; D011859:Radiography; D012086:Reoperation; D014945:Wound Healing