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The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis

Author

Listed:
  • Wojciech Konarski

    (Department of Orthopaedic Surgery, Ciechanów Hospital, 06-400 Ciechanów, Poland)

  • Tomasz Poboży

    (Department of Orthopaedic Surgery, Ciechanów Hospital, 06-400 Ciechanów, Poland)

  • Andrzej Kotela

    (Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Woycickiego 1/3, 01-938 Warsaw, Poland)

  • Andrzej Śliwczyński

    (Social Medicine Institute, Department of Social and Preventive Medicine, Medical University of Lodz, 90-419 Lodz, Poland)

  • Ireneusz Kotela

    (Department of Orthopedic Surgery and Traumatology, Central Research Hospital of Ministry of Interior, Wołoska 137, 02-507 Warsaw, Poland)

  • Martyna Hordowicz

    (General Psychiatry Unit III, Dr Barbara Borzym’s Independent Public Regional Psychiatric Health Care Center, 26-600 Radom, Poland)

  • Jan Krakowiak

    (Social Medicine Institute, Department of Social and Preventive Medicine, Medical University of Lodz, 90-419 Lodz, Poland)

Abstract

Background: Avascular necrosis (AVN) of the femoral head often requires surgical treatment and is often associated with femoral neck fractures. We conducted a systematic review and meta-analysis of recent research on the risk of AVN following the stabilization of fractured femoral neck with implants in PubMed. We assessed the effect of age on AVN incidence among patients aged > 50 and younger, depending on fracture type, Garden stage, Pouwels degree, Delbet stage, and age category. We followed PRISMA guidelines. Relevant studies were defined as research articles describing real-world studies reporting on the risk of AVN following primary surgical fracture stabilization with implants, published between 1 January 2011 and 22 April 2021. Fifty-two papers met the inclusion criteria, with a total of N = 5930 with surgically managed fractures. The pooled mean AVN incidence was significantly higher among patients with displaced fractures (20.7%; 95% CI: 12.8–28.5%) vs. those with undisplaced fractures (4.7%; 95% CI: 3.4–6.0%). No significant correlation was observed between AVN incidence weighted by sample size and time interval from injury to surgery ( p = 0.843, R 2 = 0.01). In conclusion, the risk of AVN following femoral neck fractures was generally high, especially in patients with displaced fractures. The time from injury to surgery did not correlate with AVN incidence.

Suggested Citation

  • Wojciech Konarski & Tomasz Poboży & Andrzej Kotela & Andrzej Śliwczyński & Ireneusz Kotela & Martyna Hordowicz & Jan Krakowiak, 2022. "The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(16), pages 1-16, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10050-:d:888313
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    Cited by:

    1. Wojciech Konarski & Tomasz Poboży & Andrzej Kotela & Andrzej Śliwczyński & Ireneusz Kotela & Martyna Hordowicz & Jan Krakowiak, 2022. "Does Diabetes Mellitus Increase the Risk of Avascular Osteonecrosis? A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(22), pages 1-9, November.

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