Dyslipidaemia for Patients with Low-energy Femoral Neck Fractures After the Treatment of Cancellous Screws: a Retrospective Study with a 3-year Minimum Follow-up

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2017 Nov 12

PMID 29126401

Citations 3

Authors

Chi Zhang

Xiaoxiao Zhu

Genwang Pei

Ping Xu

Xianshang Zeng

Lili Zhang

Nan Zhang

Dan Zeng

Lei Cao

Weiguang Yu

Xinchao Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Avascular necrosis of the femoral head (AVNFH) occurs infrequently following femoral neck fracture. The association between AVNFH and dyslipidaemia remains controversial. Although major risk factors for AVNFH have been proposed, most of them remain under discussion. Our purpose herein was to evaluate the association between dyslipidaemia and AVNFH following low-energy femoral neck fractures treated with cancellous screws in elderly patients in our tertiary care centre.

Methods: Four hundred and seventy-two consecutive patients (472 hips) with low-energy femoral neck fractures were identified and treated with cancellous screws from July 2007 to April 2013. Patients underwent evaluations preoperatively and each subsequent postoperative visit (months 1, 6, 12, 18, 24, 30, and 36). Clinical and radiographic evaluations were documented at each visit. The risk factors of AVNFH were assessed by multivariate binary logistic analysis.

Results: Follow-up was available for 277 patients, which included 135 patients diagnosed with AVNFH (AVNFH group) and 142 patients without AVNFH (control group). The median follow-up for patients alive at the time of analysis was 40 months (range, 37 to 46 months). The mean total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and apolipoprotein B (Apo-B) values were considerably higher in the AVNFH group compared with those in the control group. The mean high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1(Apo-A1) values were significantly lower in the AVNFH group compared with those in the control group. A multivariate logistic backward regression model showed that HDL-C and LDL-C were the only variables associated with the development of postoperative AVNFH in patients with a femoral neck fracture (Odds ratio[OR] 33.09, 95% Confidence Interval[CI]: 2.65-19.42, p < 0.001 and OR 45.94, 95% CI: 0.47-27.75, p < 0.001, respectively).

Conclusion: Our results suggest that both low HDL-C and high LDL-C have a tendency to result in the occurrence of AVNFH in elderly patients with low-energy femoral neck fractures treated with cancellous screws.

Citing Articles

The Paradoxical Association of Lipids with Survival and Walking Ability of Hip Fractures in Geriatric Patients After Surgery: A 1-Year Follow-Up Study.

Zhao Z, Fan W, Wang L, Chu Q Int J Gen Med. 2023; 16:3907-3919.

PMID: 37662501 PMC: 10473408. DOI: 10.2147/IJGM.S417499.

Development and validation of a predictive nomogram for postoperative osteonecrosis of the femoral head with cannulated screws fixation.

Zhu W, Xie K, Zhang X, Yang J, Xu L, Zhu J Ann Transl Med. 2021; 9(4):281.

PMID: 33708908 PMC: 7944296. DOI: 10.21037/atm-20-4866.

Risk factors associated with osteonecrosis of femoral head after internal fixation of femoral neck fracture:a systematic review and meta-analysis.

Xu J, Liang Z, Xiong B, Zou Q, Lin T, Yang P BMC Musculoskelet Disord. 2019; 20(1):632.

PMID: 31884960 PMC: 6935498. DOI: 10.1186/s12891-019-2990-5.

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