title: Association between injury to the retinacula of Weitbrecht and femoral neck fractures: anatomical and clinical observations.
abstract: Currently, there is no objective indicator for surgical procedures in elderly patients with femoral neck fractures. The purpose of this study was to determine the severity of damage to the retinacula of Weitbrecht based on the type of femoral neck fracture, anatomical and clinical observations. Data from 44 patients treated with artificial femoral head replacement were analyzed for the association between Garden type fracture and severity of injury to Weitbrecht's retinacula. Additionally, 18 cases (Pauwels type III fracture) after Watson-Jones surgical approach and internal fixations were used to investigate the bone healing and femoral head necrosis. Among 44 patients (Garden type was III-IV, 79.6%), significant associations were found between Garden type fracture and lateral (P < 0.001), anterior (P = 0.045), and medial (P = 0.004) retinacular injury. Significant positive Spearman correlation coefficients between Garden type and the severity of injury to Weitbrecht's retinacula were Ρ = 0.561 with P < 0.001 for lateral, Ρ = 0.338 with P = 0.025 for anterior, and Ρ = 0.469 with P = 0.001 for medial retinacula. Additionally, 4 out of 18 Pauwels type III fracture cases were observed severe damages on Weitbrecht's retinacula and resulting bone necrosis. In conclusion, this study provided the anatomical and histological correlations between fracture displacement and degree of retinacula injury.
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Jiong
authors.initials: J
authors.lastname: Mei
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Ni
authors.affiliation: Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Guoliang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Guangyao
authors.initials: G
authors.lastname: Jia
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Shiwei
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Xueliang
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Yahui
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Quan
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
keywords: Retinacula of weitbrech; femoral head necrosis; femoral neck fracture; garden-type fracture; masson staining; pauwels-type fracture