Management of Displaced Intracapsular Femoral Neck Fracture in Young Adult:hy Complications Are Still So High? Case Report of Posttraumatic Avascular Necrosis in a 30-Year-Old Man and a Brief Review

Jockey injuries during the Siena "Palio". A 72-year analysis of the oldest horse race in Italy

INTRODUCTION

Horse racing is a hazardous sport. We analyzed the incidence and characteristics of jockey injuries in a typical horse race.

METHODS

We analyzed all injuries sustained by 224 jockeys in the last 72 years.

RESULTS

It was found that in 96.1% of the races there was at least one fall and in 28.6% of the races 50% or more of the jockeys fell. In 43.4% of the falls, the jockey was taken to the emergency room. Comparing the Palio with traditional races in other countries, a higher injury incidence rate was observed for every 100 falls (109.884 vs 27-59) and a lower concussion rate/100 falls (0.97 vs 1.8-7.4).

CONCLUSION

The Palio is one of the most threatening races that continues today. Jockeys are at greater risk for a fall than any other race in the world.

WITHDRAWN: Jockey injuries during the Siena "Palio". A 72-year analysis of the oldest horse race in Italy

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Injury, 50(2) 2019 365–368, https://doi.org/10.1016/j.injury.2018.12.014. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Predictors of early failure in young patients with displaced femoral neck fractures

INTRODUCTION

This study compares early failure rates of sliding hip screw (SHS) and cannulated screw (CS) constructs in young patients.

METHODS

Patients <60 years of age, with displaced femoral neck fractures treated with CS or SHS fixation were included. Primary outcome was failure within 6 months.

RESULTS

One patient (3%) with SHS fixation and 6 patients (21%) with CS fixation failed within 6 months (P = 0.04). Regression analysis demonstrated type of fixation (P = 0.005) and reduction quality (P = 0.04) are independent predictors of early failure.

CONCLUSIONS

SHS constructs demonstrate a significantly lower short-term failure rate than CS constructs.

Injury-to-surgery interval does not affect the occurrence of osteonecrosis of the femoral head: a prospective study in a canine model of femoral neck fractures

Background

It is controversial whether an early reduction and internal fixation can reduce the occurrence of femoral neck fracture-induced osteonecrosis of the femoral head (ONFH). This prospective study was designed to reflect the relationship between injury-to-surgery interval (ISI) and traumatic ONFH based on a canine model of femoral neck fractures.

Material/Methods

Twenty-four dogs were equally divided randomly into 3 groups. A lateral L-shape approach centered left great trochanter was used for exposure of the femoral neck. A low-speed drill was used for making displaced fractures in the narrow femoral neck, with the femoral head kept in situ with ligamentum teres intact. In Group A, the fracture was immediately reduced and fixed with 3 parallel pins; while the operation was done 3 days later in Group B, and 3 weeks later in Group C. Another 2 dogs had their fractures untreated. Postoperatively, all dogs were fed separately and received regular x-ray examination. Left femoral heads were harvested for histological examination with a postoperative follow-up of 3.5 months.

Results

The canine model of femoral neck fractures could be achieved successfully. Radiological signs of post-fracture ONFH could not be detected at intervals of 2 weeks, 4 weeks, 1 month and 2 months. Histologically, there were 2 cases with ONFH in Group A, 1 case in Group B, and 2 cases in Group C. The difference had no statistical significance. For untreated fractures, obvious ONFH could be found radiologically.

Conclusions

A shorter ISI may not reduce the incidence of fracture-induced ONFH, which suggests that intrinsic factors play an important role in the occurrence of ONFH.