Not all Garden-I and II femoral neck fractures in the elderly should be fixed: effect of posterior tilt on rates of subsequent Arthroplasty

Abstract

Background: Internal fixation is the best method for the treatment of Garden I and II in elderly patients. However, there is a chance of failure due to the more than 20° tilt, as measured in the radiography.
Objective: This work aims to identify the correlation between the posterior tilt and the consecutive arthroplasty risk in elderly patients who had undergone Garden I and II neck fractures.
Methods: This research is a secondary analysis of data collected in the FAITH trial, which compared the cannulated screw with the sliding hip screw in the treatment of the femoral neck fracture. This study included patients in the fifty year age group. All the patients had Garden I or II neck fractures (femoral) from the posterior tilt, which amounted to above 20° or <20°. The multivariate proportional analysis was utilized for assessment of the rear tilt and consecutive arthroplasty correlation for the 24 month follow up period.
Result: Out of the 555 patients, 67 patients had a 20°tilt, and 488 had <20°tilt. About 73 out of 555 patients had undergone consecutive arthroplasty in the two year follow up duration in the multivariate analysis with the posterior tilt <20° which are at a lesser risk of consecutive arthroplasty as compared to the posterior tilt with 20° (p value= 0.008; CI(95%)=1.24). In contrast, the other factors that are linked with the consecutive arthroplasty are the 8p year age group (p value=0.03).
Conclusion: Patients with the Garden I and II neck fracture analysis posterior tilt of 20° is correlated with the significant risk of consecutive arthroplasty. Patients with the Garden I and II neck fracture (femoral) with 20°tilt areconsidered for the primary arthroplasty.