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Coronal shear fractures of the femoral neck: a comparison with basicervical fractures

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

We propose coronal shear fracture of the femoral neck (CSFF) as a new type of fracture that differs from a basicervical fracture. This study aimed to present the incidence of CSFF and compare its clinical characteristics and outcomes with those of basicervical fractures.

Methods

In this multicenter retrospective cohort study, 2207 patients with hip fractures were identified using computed tomography (CT), 17 and 27 patients were diagnosed with CSFF (CSFF group) and basicervical fractures (basicervical fracture group), respectively. The primary outcome was reoperation, while the secondary outcomes were postoperative radiographic findings, ambulatory ability, and 1-year mortality rate. These outcomes were compared between the two groups. We also conducted diagnostic reliability tests for these fractures using the Cohen’s kappa coefficient.

Results

The incidence of CSFF and basicervical fractures in the 2207 patients were 0.77% and 1.22%, respectively. The inter-and intra-observer agreements for the diagnosis were almost perfect. The comorbidity score was significantly higher in the CSFF group than in the basicervical fracture group. No reoperations occurred in both groups. There were no significant intergroup differences in the postoperative radiographic findings. The 1-year mortality rate was higher in the CSFF group than in the basicervical fracture group (38.5% vs. 5.3%; odds ratio: 11.9, 95% CI: 1.2–118.5; p = 0.025).

Conclusion

This study presents the definition and incidence of CSFF with a high diagnostic reliability. Patients with CSFF had similar reoperation rate postoperative radiographic outcomes to basicervical fractures, while 1-year mortality rate was high.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kochi Health Sciences Center, Kochi, Japan

    Yasuaki Yamakawa & Toshiyuki Matsumoto

  2. Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan

    Norio Yamamoto, Tomoo Inoue & Keisuke Kawasaki

  3. Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan

    Norio Yamamoto

  4. Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan

    Yosuke Tomita

  5. Department of Orthopaedic Surgery and Traumatology, Kawasaki Medical School General Medical Center, Okayama, Japan

    Tomoyuki Noda

  6. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Toshifumi Ozaki

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  1. Yasuaki Yamakawa
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  2. Norio Yamamoto
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  3. Yosuke Tomita
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  8. Toshifumi Ozaki
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Contributions

All authors contributed to the study conception and design. Data collection was performed by YY, NY, and TI. YY conducted statistical analysis. The first draft of the manuscript was written by NY and YT. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Norio Yamamoto.

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Conflict of interest

The authors have no conflicts of interest to declare relevant to the content of this article.

Ethical approval

The study protocol was approved by the ethics committee (approval no. 201051).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Appendix 1

Appendix 1

See Fig. 7.

Fig. 7
figure 7

Kaplan–Meier curves showing the cumulative survival probability in the CSFF and basicervical groups, in one year

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Yamakawa, Y., Yamamoto, N., Tomita, Y. et al. Coronal shear fractures of the femoral neck: a comparison with basicervical fractures. Eur J Trauma Emerg Surg 49, 419–430 (2023). https://doi.org/10.1007/s00068-022-02079-7

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  • DOI: https://doi.org/10.1007/s00068-022-02079-7

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