Advances in Orthopedics最新文献

{"title":"The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review.","authors":"Thomas Gatt,&nbsp;Adriana Grech,&nbsp;Homa Arshad","doi":"10.1155/2023/6236045","DOIUrl":"https://doi.org/10.1155/2023/6236045","url":null,"abstract":"<p><p>While most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clinical or radiological union complications. The secondary aims were to assess supplementation effect on patient functional outcome scores and bone mineral density (BMD). A systematic search of all relevant articles was performed using the following databases: MEDLINE, Embase, Google Scholar, and Web of Science. The population selection included human patients with a fresh fracture treated conservatively or operatively. The intervention included any form of vitamin D supplementation, compared to no supplementation or a placebo. The primary outcomes assessed were clinical or radiological union rates or complications arising from the nonunion. The secondary outcomes assessed were functional outcome scores, BMD scores after treatment, and pain scores. A total of fourteen studies, assessing a total of 2734 patients, were included. Eight studies assessed the effect of vitamin D on clinical or radiological union. Five studies reported no significant difference in complication rates when supplementing fracture patients. Alternatively, three studies reported a positive effect with supplementation between the groups. One of these studies found a difference only for early orthopaedic complications (<30 days), but no differences in late complications. The other two studies found significant differences in clinical union; however, no changes were observed in radiological union. Six studies investigated functional outcome scores after supplementation. Four of these studies found no significant differences between most functional outcome scores. Only three studies reported BMD outcomes, one of which found limited effect on total hip BMD. The overall findings are that vitamin D alone does little to influence fracture healing and subsequent union rates or functional outcome. The studies suggestive of a positive effect were generally of a lower quality. Further high quality RCTs are needed to justify routine supplementation at the time of fracture.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2023 ","pages":"6236045"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9084924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review.","authors":"Phillip Wyatt, James Satalich, Zylyftar Gorica, Conor O'Neill, John Cyrus, Alexander Vap, Robert O'Connell","doi":"10.1155/2022/8672113","DOIUrl":"10.1155/2022/8672113","url":null,"abstract":"<p><strong>Introduction: </strong>The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial patellofemoral ligament reconstruction, tibial tuberosity transfer (TTT), trochleoplasty, and tibial derotation osteotomy (TDO). The purpose of this systematic review is to investigate the safety and efficacy of TDO for PF instability and pain.</p><p><strong>Methods: </strong>A thorough search of the literature was conducted on July 15, 2022. Seven studies met the inclusion criteria for this systematic review.</p><p><strong>Results: </strong>Among the included studies, there were 179 total subjects and 204 operative knees. Mean follow-up time was 66.31 months (range 11-192). Complication rate was low (12.8%) in studies that reported complications. Average degree of anatomical correction in the transverse plane was 19.9 degrees with TDO. This increased to 34 degrees when combined with TTT. All PROMs assessed were significantly increased postoperatively (<i>p</i> < 0.05). Age greater than 25 years and advanced PF chondromalacia may negatively affect postoperative outcomes.</p><p><strong>Conclusion: </strong>The primary findings of this review were as follows: (1) TDO results in significantly improved pain and PROM ratings in patients with PF pain and/or instability, (2) the likelihood of complication, including recurrent patella subluxation after TDO, is low but may be increased by aging, and (3) the successful anatomical correction of TDO may be augmented by concurrent TTT in some cases.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 ","pages":"8672113"},"PeriodicalIF":1.2,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Red Cell Salvage Systems in Open Acetabular Surgery","authors":"S. MacDonald, C. Byrd, E. Barlow, V. Nahar, J. Martin, D. Krenk","doi":"10.1155/2022/8276065","DOIUrl":"https://doi.org/10.1155/2022/8276065","url":null,"abstract":"Over the past 50 years, treatment of displaced acetabular fractures has moved away from conservative treatment with bedrest to operative intervention to achieve anatomic reduction, stable fixation, and allow early range of motion of the hip. However, operative fixation is not without complications. Internal fixation of traumatic acetabular fractures has been coupled with large volume of blood loss both at the time of injury and surgery. This often results in the need for allogenic blood products, which has been linked to increase morbidity (Vamvakas and Blajchman, 2009). In an attempt to avoid the risk associated with allogenic blood transfusion numerous techniques and methods have been devised. Red blood cell salvage (CS) is an intraoperative blood salvage tool where blood is harvested from the operative field. It is washed to remove the plasma, white blood cells, and platelets. The red cells are resuspended in a crystalloid solution. If the hematocrit of the resuspended red blood cells is sufficient, it is transfused to the patient intravenously. The benefits of CS in major spine surgery, bilateral knee replacement, and revision hip surgery are well established (Goulet et al. 1989, Gee et al. 2011, Canan et al. 2013). However, literature reviewing the use of cell saver in orthopedic trauma surgery, specifically acetabular surgery is limited. Our institute performed a retrospective review of 63 consecutive operative acetabular fractures at a level one trauma center. Our study revealed that patients with blood loss of less than 400 mL were 13 times less likely to receive autologous blood, and patients with hemoglobin less than 10.5 were 5 times less likely to receive autologous transfusion (p < 0.05). We also found that no patients with a hemoglobin level less than 10.5 and EBL less than 400 mL received autologous blood return. Autologous blood transfusion had no effect on volume or rate of allogenic blood transfusion. We believed that if a patient's preoperative hemoglobin is less than 10.5 or expected blood loss is less than 400 mL, then CS should have a very limited role, if any, in the preoperative blood conservation strategy. We found ASA greater than 2, BMI greater than 24 and associated fracture type to be a risk factor for high blood loss.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45434524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Safety and Efficacy of Traction, Closed Reduction, and Subsequent Hip Fixation in Hilgenreiner Brace in Patients with Severe Forms of Hip Developmental Dysplasia","authors":"A. Gharaibeh, Rastislav Sepitka, Jan Pobeha, D. Schreierova, Martina Habinakova, G. Vaško, M. Lacko","doi":"10.1155/2022/8688770","DOIUrl":"https://doi.org/10.1155/2022/8688770","url":null,"abstract":"Background Hilgenreiner brace (Hb) was developed to improve hip reduction rate and reduce the incidence of femoral head avascular necrosis (AVN). In children under the age of 18 months with unstable hip joints or a dislocated hip joint, the treatment method involves nonsurgical treatment in most cases. Objectives To evaluate the effectiveness and safety of traction, closed reduction, and hip fixation in Hb in patients with severe forms of hip developmental dysplasia (DDH) in follow-up. Materials and Methods Prospective, clinical, cohort observation and retrospective matched-pair analysis. Analysis of medical records was conducted to evaluate the effectiveness of using Hb for treatment of dislocated hip joints in <18-month-old children. The investigated cases were of the dislocated hip joint since DDH was confirmed through clinical and imaging diagnosis and treated by the application of the close reduction method together with Hb, in a nonhuman position (hip joint in 90 degrees of flexion and 80 degrees of abduction). Analysis was carried out using the modified Berkeley's Mckay criteria and hip joint centralization, and evaluation was done using X-ray images according to the basic modified Severin classification system. Results The use of Hb applied after overhead traction to (mean 22.8 days, confidence level (95%)) 68 hip joints showed a significant improvement (92%) in the treated hips. In summary, only one brace replacement was performed due to swelling of the thigh and fixation pressure, three cases suffered from hip joint redislocation after removing the Hb (5%), and one patient had bilateral avascular necrosis (2.8%). Conclusions The use of Hb reduced avascular necrosis of the femur head, maintained higher hygiene conditions, and lowered both the risk of cast breakage and skin complications over the use of hip spica as compared to Hb. Hb is more cost-effective, and radiolucency is an additional advantage for this technique. Closed reduction and application of Hb after oral administration of a bolus dose of chlorpromazine chloride or phenobarbital resulted in complication avoidance of total anaesthesia.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49342507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Crossover Sign in Pelvis Models Made with a Three-Dimensional Printer","authors":"A. Salimi, S. P. Mirghaderi, M. J. Gholamzadeh, Reihane Qahremani, A. Hadizadeh, Reza Shahriarirad, Hesan Jelodari Mamaghani, J. Dehghani, Maryam Salimi","doi":"10.1155/2022/4665342","DOIUrl":"https://doi.org/10.1155/2022/4665342","url":null,"abstract":"Introduction Investigation of the crossover sign (COS) in different degrees of tilt in pelvises made by three-dimensional printing of CT scans among patients with normal hip versions was carried out. Methods Radiology CT scans of 8 normal pelvises reconstructed in 3D and the effect of sequential tilting on the presence of the false-positive COS in 48 radiographs were investigated. Results The COS was seen in 77% of the AP radiographs during tilt changes. The average distance between the tip of the coccyx and the symphysis pubis was 32.06 ± 10.99 mm. Also, COSs were present in all radiographs from 6 degrees tilt and above. Conclusion Minor tilting of the pelvis can result in a false-positive crossover sign on AP plain radiographs.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44971522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells in Association with Arthroscopic Microfracture of Knee Articular Cartilage Defects: A Pilot Randomized Controlled Trial","authors":"M. Venosa, Francesco Calafiore, M. Mazzoleni, E. Romanini, S. Cerciello, V. Calvisi","doi":"10.1155/2022/6048477","DOIUrl":"https://doi.org/10.1155/2022/6048477","url":null,"abstract":"Background This study aims to compare the effects of platelet-rich plasma (PRP) alone or in combination with adipose-derived mesenchymal stem cells (AD-MSCs) in patients affected by cartilage defects, undergoing knee arthroscopic microfracture. Methods Thirty-eight patients diagnosed with a knee monocompartmental cartilage defect (Outerbridge grade IV) on the MRI, underwent an arthroscopic procedure. After the confirmation of the lesion, they all received the same bone marrow stimulation technique (microfracture) and were randomized into two groups: the first one had additional PRP injection (group A), while the second received PRP and AD-MSC injection (group B). Knee assessment and pain score were documented with Knee Injury Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Short-Form (SF) 12, and Visual Analogue Scale (VAS) before the treatment and at 1, 3, 6, and 12 months of follow-up postoperatively. An additional arthroscopic procedure, performed in four patients for a subsequent meniscal lesion, let us evaluate cartilage evolution by performing a macro/microscopical assessment on cartilage biopsy specimens. Results At the 12-month follow-up, both groups showed a comparable functional improvement. The scores on the IKDC form, KOOS, pain VAS, and SF-12 significantly improved from baseline (p < 0.05) to 12 months postoperatively in both treatment groups. The four second-look arthroscopies showed a complete repair of the articular defects by smooth solid cartilage layer, with a good chondrocytic population, in both groups. A thick smooth hyaline-like cartilage with a predominantly viable cell population and normal mineralization (a form closely resembling native tissue) was observed in group B. Conclusions Modern regenerative medicine techniques, such as PRP and AD-MSC, associated with traditional arthroscopic bone marrow stimulating techniques, seem to enhance cartilage restoration ability. The preliminary results of this pilot study encourage the synergic use of these regenerative modulating systems to improve the quality of the regenerated cartilage.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48554122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Biomimetic Approaches for Articular Cartilage Tissue Engineering and Their Clinical Applications: Narrative Review of the Literature","authors":"Hamza Abu Owida","doi":"10.1155/2022/8670174","DOIUrl":"https://doi.org/10.1155/2022/8670174","url":null,"abstract":"Since articular cartilage is lacking blood vessels and nerves, its capacity to heal is extremely limited. This means that ruptured cartilage affects the joint as a whole. A health issue known as osteoarthritis can develop as a result of injury and deterioration. Osteoarthritis development can be speeded up by the widespread deterioration of articular cartilage, which ranks third on the list of musculoskeletal disorders requiring rehabilitation, behind only low back pain and broken bones. The current treatments for cartilage repair are ineffective and rarely restore full function or tissue normalcy. A promising new technology in tissue engineering may help create functional cartilage tissue substitutes. Ensuring that the cell source is loaded with bioactive molecules that promote cellular differentiation and/or maturation is the general approach. This review summarizes recent advances in cartilage tissue engineering, and recent clinical trials have been conducted to provide a comprehensive overview of the most recent research developments and clinical applications in the framework of degenerated articular cartilage and osteoarthritis.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41345665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Predictors of Patients with Fracture in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia: A Prospective Cohort Study","authors":"Beminet Yimenu, Belayneh Mengist","doi":"10.1155/2022/3747698","DOIUrl":"https://doi.org/10.1155/2022/3747698","url":null,"abstract":"Background Fracture continues to be a major public health concern in many parts of the developing world that results in several consequences and complications including lifelong morbidity and mortality. This study aimed to assess clinical outcomes of patients following fracture in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia. Methods An institution-based prospective cohort study was conducted from November 2020 to July 2021 among 207 fracture patients (69 visited traditional bone setter and 138 did not visit traditional bone setter). Data were collected through face-to-face interviews, physical examinations, and radiological investigations. Data were entered using Epi-Data version 3.1 and analysis was done using STATA 14 statistical software. Descriptive statistics were summarized using mean, median, standard deviation, and percentage and presented in tables and figures. The generalized linear model was fitted to identify the risks of the outcome variable. Risk Ratio with its 95% confidence interval was used and factors with a P-value less than 0.05 were considered as a statistically significant association. Result The mean age of the participants was 37.5 ± 13.6 years and two-thirds of the participants were males. Nearly half of the patients 92 (44%), 50 (54%) from the exposed and 42 (46%) from the nonexposed group, were delayed getting treatment from the hospital. The majority of the patients had been treated with Plaster of Paris immobilization (55%) followed by fixation (15%) and a combination of both (12%). Nearly half of the participants (48%), 74% from the exposed and 35% from the nonexposed group, developed complications during the follow-up period. The commonest complication was joint stiffness (45%) followed by osteoarthritis (21%). The risk of fracture-related complications among patients who did not visit traditional bone setter was decreased by 54% as compared to visitors (RR 0.46; 95% CI: (0.35, 0.60)) Conclusion The magnitude of complications following the fracture is found to be high and the risk of complications among patients who visited traditional bone setters increased significantly. Therefore, prevention measures should be strengthened and integration between hospitals and traditional bone setters should be made so that basic training on fractures management will be given.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49334265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellofemoral Pain Syndrome in Young Female Athletes: A Case-Control Study","authors":"V. Pavone, A. Vescio, Flora Maria Chiara Panvini, Ludovico Lucenti, Alessia Caldaci, M. Sapienza, F. Canavese, G. Testa","doi":"10.1155/2022/1907975","DOIUrl":"https://doi.org/10.1155/2022/1907975","url":null,"abstract":"Background Patellofemoral pain syndrome (PFPS) is the most common cause of anterior knee pain in children and adolescents, and it is characterized by highly limiting, recurrent, frontal pain. Objectives The purpose of the study is to assess the incidence and onset of PFPS in the young female athletes and to compare it to healthy individuals. Methods Between 2017 and 2019, 51 subjects were reviewed and divided in three groups: rhythmic gymnastics athletes (RG; 21 individuals, mean age: 13.8 ± 3.6 years), basketball athletes (BG; 17 individuals, mean age: 14.2 ± 3.1 years), and control group (CG; 13 individuals, mean age: 14.5 ± 4.3 years). All patients underwent physical examination including patellar glide, tilt, grind and apprehension tests, tiptoe and jack tests, Coleman block, and navicular drop tests. The clinical and functional outcomes of the subjects were assessed using the Kujala patellofemoral score (KPS). Results In RG patients were recorded 66.7% of normal footprint (NF), 9.5% of cavus feet (FCF), and 23.8% of flatfeet (FFF); 14.8% patellar positive tests, KS = 98.6 ± 13.7. BG patients had 70.6% of NF, 11.8% FCF, and 17.6% of FFF; 23.5% patellar positive tests, KS = 98.3 ± 12.4. CG patients had 61.5% of NF, 7.7% of FCF and 30.8% of FFF; 15.4% patellar positive tests, KPS = 98,9 ± 15.3. No statistically significance was found between the three cohorts of patients. Conclusions PFPS is a common pathology; muscular imbalance and overuse could exacerbate pain and discomfort in young female athletes. Our findings show high type and level of sport activity are not related to increase frequency of clinical symptoms related to PFPS.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42494331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixator-Assisted Nailing for Femur Neck Fracture Nonunion: A Case Series Study","authors":"Majdi Hashem, Mohammad S. Al-Tuwaijri","doi":"10.1155/2022/5676144","DOIUrl":"https://doi.org/10.1155/2022/5676144","url":null,"abstract":"Background Femoral neck fractures in young adults tend to be a result of high-energy trauma with a common pattern of Pauwels type III fracture, and they require timely and meticulous diagnosis and management. The objective of this study was to assess the clinical and radiological outcomes of the fixator-assisted nailing technique for managing femur neck fracture nonunion. Methods. This was a case series study of 16 patients with nonunion femoral neck fractures treated via a fixator-assisted nailing technique. Our inclusion criteria comprised the inclusion of any patient between the ages of 14 and 60 years old with a neglected neck of femur fracture or nonunion of the femur neck. In addition, we only included patients without further posttreatment trauma and without known metabolic diseases. The conditions that were excluded from this study included hip joints with preexisting osteoarthritis, radiographic evidence of avascular necrosis of the femoral head, and associated ipsilateral acetabulum fracture or fracture-dislocation. The fracture characteristics that were selected for the fixator-assisted nailing (FAN) technique were clear signs of pseudoarthrosis (such as sclerosis, clear fracture line defects, and failure of implants), in addition to evidence of varus malalignment. All fractures were Pauwels type III. Radiographs of the pelvis with both hips and a posteroanterior (PA) view of the injured hip were taken. Full weight bearing was allowed in all the patients from the first day postoperatively. Physical therapy was started for pain reduction modalities, stretching, and abductor strengthening. Results Union of the femur neck fracture and osteotomy site was achieved in all patients. An excellent functional status after four months of follow-up was found based on a modified Harris hip score questionnaire. At follow-up, no patient was suffering from pain or flexion contracture. Preoperative limb length discrepancy (LLD) (cm) was 1.8 ± 0.8 cm and postoperative was 0 ± 0.1 cm, p < 0.001. Preoperative neck-shaft angle (NSA) (o) was 85.6 ± 4.4 and postoperative was 126.9 ± 2.5, p < 0.001. Preoperative Pauwels angle (o) was an average of 50.4 ± 5.9 and postoperative was 31.3 ± 2.5, p < 0.001. Conclusion Our study indicates that FAN has a high success rate in young patients with nonunited femoral neck fractures.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48887315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}