![]() Some scholars believe that Garden II in the elderly can be treated with cannulated screw internal fixation, while some recommend hip arthroplasty because Garden II is complete FNF and osteoporosis exits in the elderly, which result in high rate of nonunion and femoral head necrosis after internal fixation. Most scholars believe that Garden I is incomplete FNF, and can be treated by cannulated screw internal fixation, while there is much controversy over the treatment of Garden II in the elderly. However, the treatment of incomplete FNF or undisplaced FNF (Garden I and II) still remains controversial. Currently, orthopedic surgeons prefer hip arthroplasty for treating displaced FNF (Garden III and IV). The type of fractures is one of the important factors determining the treatment programs. Such fractures are rarely treated conservatively, but usually treated by cannulated screw internal fixation, femoral head arthroplasty or total hip arthroplasty. Totally 4.5 million elderly people worldwide become disabled due to hip fractures every year, including about 1.7 million patients with FNF. The incidence rate of femoral neck fractures (FNF) is high, especially in the elderly. In the elderly, all undisplaced femoral neck fracture may be Garden II, no Garden I. There was low consistency and repeatability in 4 types Garden classification (I, II, III and IV), while 3 types Garden classification (I + II, III and IV) had high consistency among observers. All surgical cases showed complete fracture during operation. ![]() Totally 52 patients were diagnosed as Garden I, 38 of whom underwent arthroplasty. 3 types Garden classification showed almost perfect agreement inter- and intraobservers, which ranged from 0.76 to 0.90. Resultsįour types Garden classification, there was little consistency inter- and intraobservers (Kappa from 0.18 to 0.43) based on X-ray images, while professors consistency (0.56 to 0.76) was higher than residents (0.28 to 0.35) based on CT. The patients with Garden I incomplete FNF confirmed by 8 observers together based on images combined with medical history were compared with the intraoperative results. Kappa was used to measure inter- and intraobserver agreement. Three months later, The exercise was repeated and the results were compared based on 4 types Garden classification (I, II, III and IV) and 3 types Garden classification (I + II, III and IV). X-ray and CT images from 886 elderly patients with FNF were collected, four orthopaedic surgeons and four radiologists evaluated these images independently, and determined the fracture type based on Garden classification. The aim of this study was to evaluate the stability and consistency of Garden classification based on X and CT images, and to analyze whether it is valid for Garden I in the elderly. Garden classification is commonly used in the clinic, but its stability and consistency remain controversial. Accurate classification of femoral neck fracture (FNF) is crucial for treatment plan and therapeutic outcomes.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |