CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD

Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially co...

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Main Authors:	Astur, Diego da Costa, Arliani, Gustavo Gonçalves, Nascimento, Carolina Lins e Silva, Blumetti, Francesco Camara, Fonseca, Marcio José Alher, Dobashi, Eiffel Tsuyoshi, Pinto, José Antonio, Ishida, Akira
Format:	Online
Language:	English
Published:	Elsevier 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799117/

id	pubmed-4799117
recordtype	oai_dc
spelling	pubmed-47991172016-03-28 CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD Astur, Diego da Costa Arliani, Gustavo Gonçalves Nascimento, Carolina Lins e Silva Blumetti, Francesco Camara Fonseca, Marcio José Alher Dobashi, Eiffel Tsuyoshi Pinto, José Antonio Ishida, Akira Original Article Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially considered the relationship between establishment of avascular necrosis and the time between the accident and the therapeutic intervention. Method: We retrospectively studied proximal extremity fractures of the femur in 29 patients under 14 years of age between 1988 and 2007. We analyzed the following variables: sex, age, mechanism of injury, fracture classification (Delbet), treatment administered, complications (pseudarthrosis, varus deformity, leg length discrepancy and avascular necrosis), duration of surgery and results (Ratliff). We carried out individual descriptive analysis on each variable. The tests were used in accordance with the premise that normality applied. For the evaluation, we used Fisher's exact test. Results: Five patients (17.2%) had avascular necrosis, and three of them (60.0%) were over 10 years of age. 73.3% of the patients treated within the first 24 hours showed good results. The most common cause of fractures was traffic accidents (44.8%). The best results were observed among patients who were treated surgically. 41.4% developed some type of complication. Conclusions: Among the 29 patients treated, 58.6% had good, 27.6% had regular and 13.8% had poor results, according to the Ratliff criteria. When conservative treatment was applied, only 17.0% had good results, while 69.3% had good results from surgical intervention. Likewise, 73.3% of the results were good results when surgery was performed within the first 24 hours and only 42.8% of the results were good among patients who underwent surgery after this period. Patients operated within the first 24 hours developed necrosis of the femoral head in 13.3% of cases, while 21.4% of those operated after this period developed this complication. Elsevier 2015-11-17 /pmc/articles/PMC4799117/ /pubmed/27022575 http://dx.doi.org/10.1016/S2255-4971(15)30392-X Text en © 2010 Sociedade Brasileira de Ortopedia e Traumatologia http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Astur, Diego da Costa Arliani, Gustavo Gonçalves Nascimento, Carolina Lins e Silva Blumetti, Francesco Camara Fonseca, Marcio José Alher Dobashi, Eiffel Tsuyoshi Pinto, José Antonio Ishida, Akira
spellingShingle	Astur, Diego da Costa Arliani, Gustavo Gonçalves Nascimento, Carolina Lins e Silva Blumetti, Francesco Camara Fonseca, Marcio José Alher Dobashi, Eiffel Tsuyoshi Pinto, José Antonio Ishida, Akira CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
author_facet	Astur, Diego da Costa Arliani, Gustavo Gonçalves Nascimento, Carolina Lins e Silva Blumetti, Francesco Camara Fonseca, Marcio José Alher Dobashi, Eiffel Tsuyoshi Pinto, José Antonio Ishida, Akira
author_sort	Astur, Diego da Costa
title	CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_short	CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_full	CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_fullStr	CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_full_unstemmed	CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
title_sort	correlation between avascular necrosis and early stabilization of proximal femoral fractures in childhood
description	Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially considered the relationship between establishment of avascular necrosis and the time between the accident and the therapeutic intervention. Method: We retrospectively studied proximal extremity fractures of the femur in 29 patients under 14 years of age between 1988 and 2007. We analyzed the following variables: sex, age, mechanism of injury, fracture classification (Delbet), treatment administered, complications (pseudarthrosis, varus deformity, leg length discrepancy and avascular necrosis), duration of surgery and results (Ratliff). We carried out individual descriptive analysis on each variable. The tests were used in accordance with the premise that normality applied. For the evaluation, we used Fisher's exact test. Results: Five patients (17.2%) had avascular necrosis, and three of them (60.0%) were over 10 years of age. 73.3% of the patients treated within the first 24 hours showed good results. The most common cause of fractures was traffic accidents (44.8%). The best results were observed among patients who were treated surgically. 41.4% developed some type of complication. Conclusions: Among the 29 patients treated, 58.6% had good, 27.6% had regular and 13.8% had poor results, according to the Ratliff criteria. When conservative treatment was applied, only 17.0% had good results, while 69.3% had good results from surgical intervention. Likewise, 73.3% of the results were good results when surgery was performed within the first 24 hours and only 42.8% of the results were good among patients who underwent surgery after this period. Patients operated within the first 24 hours developed necrosis of the femoral head in 13.3% of cases, while 21.4% of those operated after this period developed this complication.
publisher	Elsevier
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799117/
_version_	1613554748933275648

CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD

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