Does capsulotomy in closed reduction of garden type 3 femoral neck fractures decrease incidence of avascular necrosis? A randomized controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(12):53 Eur J Orthop Surg Traumatol . 2025 Apr 10;35(1):155.What this means for my practice?
Capsulotomy added to CRIF for Garden III femoral neck fractures may reduce early complications like AVN and non-union and improve early functional recovery. Clinically, it suggests that capsulotomy could be a valuable adjunct to enhance outcomes in younger adults with this fracture type. However, the small sample size and limited follow-up duration are key limitations that warrant further larger-scale research.
Study Summary
Sixty-seven patients with Garden III femoral neck fractures were randomized to receive either closed reduction and internal fixation (CRIF) with capsulotomy (n=32) or CRIF alone (n=35). The primary outcome was the incidence of avascular necrosis (AVN). Secondary outcomes included non-union rates, Harris Hip Score (HHS), blood loss, and operative parameters. Outcomes were assessed at 3 and 6 months. Overall, the results of the study revealed that the capsulotomy group had a lower incidence of AVN and non-union, along with significantly better early functional outcomes and faster fracture union. These findings suggest that adding capsulotomy to CRIF may reduce complications and improve early recovery in this patient population.
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