Smith–Petersen Versus Watson–Jones Approach Does Not Affect Quality of Open Reduction of Femoral Neck Fracture

Objective: To compare immediate quality of open reduction of femoral neck fractures by alternative surgical approaches. Design: Retrospective cohort study. Setting: Twelve Level 1 North American trauma centers. Patients: Eighty adults 18–65 years of age with isolated, displaced, OTA/AO type 31-B2 or -B3 femoral neck fractures treated with internal fixation. Intervention: Thirty-two modified Smith–Petersen anterior approaches versus 48 Watson–Jones anterolateral approaches for open reduction performed by fellowship-trained orthopaedic trauma surgeons. Main outcome: Reduction quality as assessed by 3 senior orthopaedic traumatologists as “acceptable” or “unacceptable” on AP and lateral postoperative radiographs. Results: No difference was observed in the rate of acceptable reduction by modified Smith–Petersen (81%) versus Watson–Jones (81%) approach (risk difference null, 95% confidence interval −17.4% to 17.4%, P = 1.00) with 90.4% panel agreement (Fleiss' weighted κ = 0.63, P
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research