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Surgical Hip Dislocation Is a Reliable Approach for Treatment of Femoral Head Fractures

Overview of attention for article published in Clinical Orthopaedics & Related Research, December 2015
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  • Above-average Attention Score compared to outputs of the same age and source (52nd percentile)

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4 tweeters
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2 Facebook pages

Citations

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23 Dimensions

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60 Mendeley
Title
Surgical Hip Dislocation Is a Reliable Approach for Treatment of Femoral Head Fractures
Published in
Clinical Orthopaedics & Related Research, December 2015
DOI 10.1007/s11999-015-4352-4
Pubmed ID
Authors

Alessandro Massè, Alessandro Aprato, Caterina Alluto, Marco Favuto, Reinhold Ganz

Abstract

Femoral head fractures are rare injuries; incongruency and instability are indications for surgical intervention. Anterior, posterior, and transtrochanteric surgical approaches have been proposed, but the exposure is limited with classical approaches. Surgical hip dislocation allows for a 360° view of the head and may facilitate a reduction in selected head fractures, but to our knowledge, few studies have reported on the results with this technique. We therefore report on the (1) quality of fracture reduction; (2) modified Harris hip score at a minimum of 2 years (mean, 6 years, range, 26-122 months); and (3) frequency of complications, including avascular necrosis (AVN), arthritis development, and heterotopic ossification, in a case series of patients with femoral head fractures treated with this approach. The procedure involves digastric trochanteric flip osteotomy and safe dislocation of the femoral head, preserving its vessels. Using this technique we are able to reduce all displaced femoral head fractures under direct view. Definitive fixation is performed through this approach with 2.7-mm nonabsorbable screws. The same technique may be used also for Pipkin IV fractures to fix transverse, T-type, posterior wall, or posterior column acetabular fracture. Between 2004 and 2011, we used this approach to manage all displaced femoral head fractures in patients younger than 55 years old. A total of 17 patients were thus treated; of those three were lost to followup before 2 years, and one was excluded from study because of severe preoperative neurological impairment, leaving 13 for analysis here. Patient demographic, injury, and surgical variables as well as complications were recorded and retrospectively evaluated. Radiographic outcome was scored according to Matta's criteria on postoperative radiographs. Outcomes were evaluated with the modified Harris hip score. Minimum followup was 24 months (mean, 77 months; SD, 32.8 months). Fracture reduction was anatomic in eight hips and imperfect in five. Mean clinical score was 82 points (SD, 7.7). One patient developed symptomatic femoral head AVN and underwent total hip arthroplasty 4 years after the index procedure; no other patient underwent arthroplasty. Besides this patient, signs of arthritis (Grade I according to Tönnis classification) were found in one patient and heterotopic ossification was recorded in two patients, but neither was symptomatic. Our experience with surgical dislocation shows clinical results comparable to previously reported outcomes in femoral head fractures treated with common approaches; we also present a similar rate of AVN and a lower rate of posttraumatic arthritis, but a higher risk of heterotopic ossification. Further case-control studies are necessary to confirm these statements. Level IV, therapeutic study.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Norway 2 3%
Unknown 58 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 15 25%
Student > Bachelor 10 17%
Other 8 13%
Researcher 8 13%
Lecturer 4 7%
Other 12 20%
Unknown 3 5%
Readers by discipline Count As %
Medicine and Dentistry 37 62%
Nursing and Health Professions 6 10%
Sports and Recreations 3 5%
Arts and Humanities 1 2%
Business, Management and Accounting 1 2%
Other 5 8%
Unknown 7 12%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 November 2015.
All research outputs
#3,660,938
of 12,983,824 outputs
Outputs from Clinical Orthopaedics & Related Research
#1,429
of 5,365 outputs
Outputs of similar age
#67,143
of 232,436 outputs
Outputs of similar age from Clinical Orthopaedics & Related Research
#47
of 102 outputs
Altmetric has tracked 12,983,824 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 5,365 research outputs from this source. They receive a mean Attention Score of 4.4. This one has gotten more attention than average, scoring higher than 73% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 232,436 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 102 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 52% of its contemporaries.