Tianjin Hospital, Tianjin University, Tianjin, 300050, China.
Tianjin Key Laboratory of Orthopedic Biomechanics and Medical Engineering, Tianjin, 300050, China.
BMC Musculoskelet Disord. 2023 Aug 1;24(1):623. doi: 10.1186/s12891-023-06737-8.
Garden I femoral neck fractures are nondisplaced femoral neck fractures. Nonoperative treatment and in situ fixation are the preferred treatments. However, the postoperative outcome is not satisfactory and the incidence of complications remains high, which raises doubts about the accuracy of the diagnosis of nondisplaced Garden I fractures. Recently, three-dimensional (3D) reconstruction has been reported as a mature technology for reconstructing the bone structure of patients. We further extended this technique in the measurement of the fracture spatial displacement to verify the accuracy of Garden I femoral neck fractures.
This was a retrospective study of patients with Garden I femoral neck fractures from January 2013 to December 2018 at our institution, who were included according to specified criteria. A bilateral proximal femur model of each patient was established based on computed tomography (CT) data. The displacement of the deepest portion of the femoral head fovea, the displacement of the center of the femoral head and the rotation of the femoral head were measured in the bilateral model.
A total of 102 patients diagnosed with Garden I fractures were included in this study. The cohort included 32 men and 70 women, with an average age of 55.88 ± 15.32 years. In these patients, the average displacement of the deepest portion of the femoral head fovea was 16.43 ± 7.69 mm. The minimum and maximum displacement was 3.58 and 44.32 mm, respectively. The average displacement of the center of the femoral head was 10.39 ± 5.47 mm and ranged from 2.16 to 34.42 mm. The rotational angle was 23.81 ± 10.15 ° and ranged from 3.71 ° to 61.19 °.
Garden I fractures have large spatial displacement and cannot be considered incomplete or nondisplaced fractures. Therefore, we suggest that anatomical reduction should be considered during treatment.
Garden I 股骨颈骨折为无移位股骨颈骨折。非手术治疗和原位固定是首选治疗方法。然而，术后效果并不理想，并发症发生率仍然较高，这引发了对无移位 Garden I 骨折诊断准确性的质疑。最近，三维（3D）重建已被报道为一种成熟的技术，用于重建患者的骨骼结构。我们进一步扩展了这项技术，用于测量骨折的空间位移，以验证 Garden I 股骨颈骨折的准确性。
这是一项回顾性研究，纳入了 2013 年 1 月至 2018 年 12 月在我院就诊的 Garden I 股骨颈骨折患者，纳入标准为：根据 CT 数据建立双侧股骨近端模型，测量股骨头最深处的位移、股骨头中心的位移和股骨头的旋转。
本研究共纳入 102 例 Garden I 骨折患者，其中男 32 例，女 70 例，平均年龄 55.88±15.32 岁。在这些患者中，股骨头最深处的平均位移为 16.43±7.69mm，最小和最大位移分别为 3.58 和 44.32mm。股骨头中心的平均位移为 10.39±5.47mm，范围为 2.16 至 34.42mm。旋转角度为 23.81±10.15°，范围为 3.71°至 61.19°。
Garden I 骨折具有较大的空间位移，不能被认为是不完全或无移位骨折。因此，我们建议在治疗过程中应考虑解剖复位。
