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2. Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries

Author

Cerezal, Luis, del Piñal, Francisco, Atzei, Andrea, Schmitt, Rainer, Becce, Fabio, Klich, Maciej, Bień, Maciej, de Jonge, Milko C., Teh, James, Boutin, Robert Downey, Toms, Andoni Paul, Omoumi, Patrick, Fritz, Jan, Bazzocchi, Alberto, Shahabpour, Maryam, Zanetti, Marco, Llopis, Eva, Blum, Alain, Lalam, Radhesh Krishna, Reto, Sutter, Afonso, P. Diana, Mascarenhas, Vasco V., Cotten, Anne, Drapé, Jean-Luc, Bierry, Guillaume, Pracoń, Grzegorz, Dalili, Danoob, Mespreuve, Marc, Garcia-Elias, Marc, Bain, Gregory Ian, Mathoulin, Christophe L., Van Overstraeten, Luc, Szabo, Robert M., Camus, Emmanuel J., Luchetti, Riccardo, Chojnowski, Adrian Julian, Gruenert, Joerg G., Czarnecki, Piotr, Corella, Fernando, Nagy, Ladislav, Yamamoto, Michiro, Golubev, Igor O., van Schoonhoven, Jörg, Goehtz, Florian, Sudoł-Szopińska, Iwona, and Dietrich, Tobias Johannes

Published
2023
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3. Interdisciplinary consensus statements on imaging of scapholunate joint instability

Author

Dietrich, Tobias Johannes, Toms, Andoni Paul, Cerezal, Luis, Omoumi, Patrick, Boutin, Robert Downey, Fritz, Jan, Schmitt, Rainer, Shahabpour, Maryam, Becce, Fabio, Cotten, Anne, Blum, Alain, Zanetti, Marco, Llopis, Eva, Bień, Maciej, Lalam, Radhesh Krishna, Afonso, P Diana, Mascarenhas, Vasco V, Sutter, Reto, Teh, James, Pracoń, Grzegorz, de Jonge, Milko C, Drapé, Jean-Luc, Mespreuve, Marc, Bazzocchi, Alberto, Bierry, Guillaume, Dalili, Danoob, Garcia-Elias, Marc, Atzei, Andrea, Bain, Gregory Ian, Mathoulin, Christophe L, del Piñal, Francisco, Van Overstraeten, Luc, Szabo, Robert M, Camus, Emmanuel J, Luchetti, Riccardo, Chojnowski, Adrian Julian, Grünert, Jörg G, Czarnecki, Piotr, Corella, Fernando, Nagy, Ladislav, Yamamoto, Michiro, Golubev, Igor O, van Schoonhoven, Jörg, Goehtz, Florian, Klich, Maciej, and Sudoł-Szopińska, Iwona

Subjects
Biomedical Imaging, Clinical Research, Bioengineering, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Musculoskeletal, Arthrography, Consensus, Humans, Joint Instability, Ligaments, Articular, Wrist Injuries, Wrist Joint, Wrist injuries, Joint instability, Diagnostic imaging, Guidelines, Surveys and questionnaires, Clinical Sciences, Nuclear Medicine & Medical Imaging
Abstract

ObjectivesThe purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique.MethodsNineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors' clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of '0', '5' and '10' reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of '8' or higher for 80% or more of the panellists.ResultsTen of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available.ConclusionsDelphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability.Key points• Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspected scapholunate joint instability. • Radiographic stress views and dynamic fluoroscopy of the wrist allow accurate diagnosis of dynamic scapholunate joint instability. • Wrist MR arthrography and CT arthrography are accurate for determination of scapholunate interosseous ligament tears and cartilage defects.

Published
2021

5. Contributing Authors

Author

Andrews, Carol L., primary, Boutin, Robert Downey, additional, Crim, Julia R., additional, Mulligan, Michael, additional, Petersilge, Cheryl A., additional, Manaster, B.J., additional, and Roberts, Catherine C., additional

Published
2018
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9. Interdisciplinary consensus statements on imaging of scapholunate joint instability

Author

Dietrich, Tobias Johannes; https://orcid.org/0000-0003-2979-6471, Toms, Andoni Paul, Cerezal, Luis, Omoumi, Patrick, Boutin, Robert Downey, Fritz, Jan, Schmitt, Rainer, Shahabpour, Maryam, Becce, Fabio, Cotten, Anne, Blum, Alain, Zanetti, Marco, Llopis, Eva, Bień, Maciej, Lalam, Radhesh Krishna, Afonso, P Diana, Mascarenhas, Vasco V, Sutter, Reto, Teh, James, Pracoń, Grzegorz, de Jonge, Milko C, Drapé, Jean-Luc, Mespreuve, Marc, Bazzocchi, Alberto, Bierry, Guillaume, Dalili, Danoob, Garcia-Elias, Marc, Atzei, Andrea, Bain, Gregory Ian, Mathoulin, Christophe L, et al, Dietrich, Tobias Johannes; https://orcid.org/0000-0003-2979-6471, Toms, Andoni Paul, Cerezal, Luis, Omoumi, Patrick, Boutin, Robert Downey, Fritz, Jan, Schmitt, Rainer, Shahabpour, Maryam, Becce, Fabio, Cotten, Anne, Blum, Alain, Zanetti, Marco, Llopis, Eva, Bień, Maciej, Lalam, Radhesh Krishna, Afonso, P Diana, Mascarenhas, Vasco V, Sutter, Reto, Teh, James, Pracoń, Grzegorz, de Jonge, Milko C, Drapé, Jean-Luc, Mespreuve, Marc, Bazzocchi, Alberto, Bierry, Guillaume, Dalili, Danoob, Garcia-Elias, Marc, Atzei, Andrea, Bain, Gregory Ian, Mathoulin, Christophe L, and et al

Abstract

OBJECTIVES The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique. METHODS Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors' clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of '0', '5' and '10' reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of '8' or higher for 80% or more of the panellists. RESULTS Ten of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available. CONCLUSIONS Delphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability. KEY POINTS • Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspe

Published
2021

10. Contributors

Author

Abascal, Faustino, primary, Adams, Judith E., additional, Ahn, Joong Mo, additional, Albareda, Jorge, additional, Allen, Gina M., additional, Anavim, Arash, additional, Anderson, Mark W., additional, Anderson, Suzanne E., additional, Aparisi, Francisco, additional, Aparisi, Pilar, additional, Armfield, Derek R., additional, Atkins, Bridget, additional, Ballehr, Lisa O., additional, Baltazar, Romulo, additional, Bancroft, Laura W., additional, Barr, Michelle S., additional, Barron, D., additional, Baur-Melnyk, Andrea, additional, Beaman, Francesca, additional, Beltran, Javier, additional, Beltran, Luis S., additional, Bencardino, Jenny T., additional, Berquist, Thomas H., additional, Biervliet, M., additional, Blankenbaker, Donna G., additional, Bloem, Hans L., additional, Bolster, Marcy B., additional, Borghei, Peyman, additional, Boutin, Robert Downey, additional, Brouwer, Patrick A., additional, Bueno, Ángel, additional, Calleja, Michele, additional, Canga, Ana, additional, Cassar-Pullicino, Victor N., additional, Cavalcanti, Conrado F.A., additional, Cerezal, Luis, additional, Chastanet, Patrick, additional, Chen, Qi, additional, Cheung, Yvonne Y., additional, Cho, Aaron, additional, Chung, Christine B., additional, Coggins, Claire, additional, Cotten, Anne, additional, Courtens, Winnie, additional, Czerny, Christian, additional, Daffner, Richard H., additional, Davies, A. Mark, additional, Davis, Kirkland W., additional, del Cura, José Luis, additional, Delman, Bradley N., additional, De Maeseneer, Michel O., additional, De Schepper, Arthur M., additional, Dheer, Sachin, additional, Dominguez, Rodrigo, additional, Donati, Davide, additional, Elaini, A. Bassem, additional, El-Khoury, Georges Y., additional, Fang, Chris, additional, Farrant, J., additional, Fayad, Laura M., additional, Ferrer, Pilar, additional, Finden, Steven, additional, Flemming, Donald J., additional, Freyschmidt, Jürgen, additional, Gibson, Michael S., additional, Gilula, Louis A., additional, Gopez, Angela Gessner, additional, Gupta, Punita, additional, Haims, Andrew, additional, Harris, John H., additional, Hayes, Curtis W., additional, Haygood, Tamara Miner, additional, Higueras, Victoria, additional, Hofmann, Siegfried, additional, Hrehorovich, Peter A., additional, Hualde, Ana M., additional, Huysse, Wouter C.J., additional, Ilaslan, Hakan, additional, Jablonka, Karsten, additional, Jennings, Bryan T., additional, Johnson, Ann M., additional, Johnson, Karl, additional, Karantanas, Apostolos, additional, Karasick, David, additional, Katsivas, Theodoros, additional, Kavanagh, Eoin C., additional, Keats, Theodore E., additional, Khan, Shah H.M., additional, Kool, Digna R., additional, Koulouris, George, additional, Kramer, Josef, additional, Kroon, Herman M., additional, van Kuijk, Cornelis, additional, Lardenoye-Bröker, Susanne W.Y., additional, Ledermann, Hans Peter, additional, Lingg, Gerwin M., additional, Liu, Brandon Y., additional, Liu, Patrick T., additional, Llopis, Eva, additional, Ma, Calvin T., additional, Marcus, Matthew A., additional, Martel, José, additional, Marten, Paul, additional, Mathew, Manesh, additional, McCall, Iain W., additional, McNally, Eugene G., additional, Mellado, José M., additional, Miller, Theodore T., additional, Mintz, Douglas N., additional, Monu, Johnny U.V., additional, Moore, Sandra L., additional, Morrison, William B., additional, Mosher, Timothy J., additional, Mulligan, Michael E., additional, Murphey, Mark D., additional, Murphy, William A., additional, Nissman, Daniel B., additional, Nomikos, George C., additional, Obermann, Willem R., additional, O'Connor, Philip J., additional, Offiah, Amaka, additional, Oh, Richard J., additional, Omar, Imran M., additional, Opsha, Oleg, additional, Ostlere, Simon, additional, Owen, Joshua M., additional, Palmer, William E., additional, Padron, Mario, additional, Paruchuri, Narayan Babu, additional, Pathria, Mini N., additional, Paylor, Rogerich T., additional, Pfirrmann, Christian W., additional, Pharoah, Michael, additional, Philippon, Marc J., additional, Pope, Thomas Lee, additional, Probyn, Linda J., additional, Rafii, Mahvash, additional, Rankine, James J., additional, Rao, Nisha, additional, Rao, Vijay M., additional, Rider, Lisa Georgianne, additional, Roberts, Catherine C., additional, Rogers, Lee F., additional, Rolón, Alejandro U., additional, Rosenberg, Zehava Sadka, additional, Rosenbloom, Lorne, additional, Rosenthal, Daniel, additional, Rubin, David A., additional, Salgado, Rodrigo A., additional, Schenk, Barry, additional, Scheurecker, Anna, additional, Schils, Jean, additional, Schorn, Corinna, additional, Schweitzer, Mark E., additional, Sekiya, Jon K., additional, Shahabpour, Maryam, additional, Shankman, Steven, additional, Smith, Roger, additional, Snoeckx, Annemie, additional, Snyder, Travis G., additional, Som, Peter M., additional, Souillard, Raphaëlle, additional, Sprigg, Alan, additional, Spouge, Alison R.I., additional, Steinbach, Lynne S., additional, Sundaram, Murali, additional, Taljanovic, Mihra S., additional, Teh, James, additional, Tehranzadeh, Jamshid, additional, Tins, Bernhard Johannes, additional, Tshering, Dechen W., additional, Tuite, Michael J., additional, Umans, Hilary, additional, Vande Berg, Bruno C., additional, Vanhoenacker, Filip M., additional, van Rijswijk, Catharina S.P., additional, Verstraete, Koenraad L., additional, Watt, Iain, additional, White, Lawrence M., additional, Williams, Helen J., additional, Willits, Kevin R., additional, Wilson, David John, additional, Yacoub, Emad, additional, Yao, Lawrence, additional, Yu, Joseph S., additional, Zelenko, Natalie, additional, Zlatkin, Michael B., additional, and Zoga, Adam C., additional

Published
2008
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12. CONTRIBUTORS

Author

Adler, Ronald S., primary, Akeson, Wayne H., additional, Boutin, Robert Downey, additional, Bugbee, William, additional, Chu, Constance R., additional, Chung, Christine B., additional, Coumas, James M., additional, Dalinka, Murray K., additional, Dwek, Jerry R., additional, Fallon, Michael D., additional, Feldman, Frieda, additional, Garfin, Steven R., additional, Goergen, Thomas G., additional, Goldman, Amy Beth, additional, Greenway, Guerdon D., additional, Guilford, W. Bonner, additional, Haghighi, Parviz, additional, Haygood, Tamara Miner, additional, Herman, Thomas E., additional, Howard, Brian A., additional, Kaplan, Phoebe A., additional, Kyriakos, Michael, additional, Mack, Laurence A., additional, Madewell, John E., additional, Manolagas, Stavros C., additional, McAlister, William H., additional, Murphy, William A., additional, Ozonoff, M.B., additional, Pathria, Mini N., additional, Pitt, Michael J., additional, Ross, Jeffrey S., additional, Rubin, David A., additional, Sartoris, David J., additional, Scheible, F. William, additional, Schneider, Robert, additional, Sofka, Carolyn M., additional, Sweet, Donald E., additional, and Weissman, Barbara N., additional

Published
2005
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15. Muscle

Author

Boutin, Robert Downey, primary, Powell, Sean T., additional, and Bracker, Mark D., additional

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16. Spiral computed tomography

Author

Boutin, Robert Downey, Ketai, Loren H., and Sell, James J.

Subjects
Innovations, CAT scans -- Innovations, CT imaging -- Innovations
Abstract

Spiral computed tomography (CT), also called helical or volumetric CT, has re-energized the field of computed tomography and presented a challenge to magnetic resonance imaging in Many situations. The technologic [...]

Published
1994

21. Contributors

Author

Abascal, Faustino, Adams, Judith E., Ahn, Joong Mo, Albareda, Jorge, Allen, Gina M., Anavim, Arash, Anderson, Mark W., Anderson, Suzanne E., Aparisi, Francisco, Aparisi, Pilar, Armfield, Derek R., Atkins, Bridget, Ballehr, Lisa O., Baltazar, Romulo, Bancroft, Laura W., Barr, Michelle S., Barron, D., Baur-Melnyk, Andrea, Beaman, Francesca, Beltran, Javier, Beltran, Luis S., Bencardino, Jenny T., Berquist, Thomas H., Biervliet, M., Blankenbaker, Donna G., Bloem, Hans L., Bolster, Marcy B., Borghei, Peyman, Boutin, Robert Downey, Brouwer, Patrick A., Bueno, Ángel, Calleja, Michele, Canga, Ana, Cassar-Pullicino, Victor N., Cavalcanti, Conrado F.A., Cerezal, Luis, Chastanet, Patrick, Chen, Qi, Cheung, Yvonne Y., Cho, Aaron, Chung, Christine B., Coggins, Claire, Cotten, Anne, Courtens, Winnie, Czerny, Christian, Daffner, Richard H., Davies, A. Mark, Davis, Kirkland W., del Cura, José Luis, Delman, Bradley N., De Maeseneer, Michel O., De Schepper, Arthur M., Dheer, Sachin, Dominguez, Rodrigo, Donati, Davide, Elaini, A. Bassem, El-Khoury, Georges Y., Fang, Chris, Farrant, J., Fayad, Laura M., Ferrer, Pilar, Finden, Steven, Flemming, Donald J., Freyschmidt, Jürgen, Gibson, Michael S., Gilula, Louis A., Gopez, Angela Gessner, Gupta, Punita, Haims, Andrew, Harris, John H., Jr., Hayes, Curtis W., Haygood, Tamara Miner, Higueras, Victoria, Hofmann, Siegfried, Hrehorovich, Peter A., Hualde, Ana M., Huysse, Wouter C.J., Ilaslan, Hakan, Jablonka, Karsten, Jennings, Bryan T., Johnson, Ann M., Johnson, Karl, Karantanas, Apostolos, Karasick, David, Katsivas, Theodoros, Kavanagh, Eoin C., Keats, Theodore E., Khan, Shah H.M., Kool, Digna R., Koulouris, George, Kramer, Josef, Kroon, Herman M., van Kuijk, Cornelis, Lardenoye-Bröker, Susanne W.Y., Ledermann, Hans Peter, Lingg, Gerwin M., Liu, Brandon Y., Liu, Patrick T., Llopis, Eva, Ma, Calvin T., Marcus, Matthew A., Martel, José, Marten, Paul, Mathew, Manesh, McCall, Iain W., McNally, Eugene G., Mellado, José M., Miller, Theodore T., Mintz, Douglas N., Monu, Johnny U.V., Moore, Sandra L., Morrison, William B., Mosher, Timothy J., Mulligan, Michael E., Murphey, Mark D., Murphy, William A., Jr., Nissman, Daniel B., Nomikos, George C., Obermann, Willem R., O'Connor, Philip J., Offiah, Amaka, Oh, Richard J., Omar, Imran M., Opsha, Oleg, Ostlere, Simon, Owen, Joshua M., Palmer, William E., Padron, Mario, Paruchuri, Narayan Babu, Pathria, Mini N., Paylor, Rogerich T., Pfirrmann, Christian W., Pharoah, Michael, Philippon, Marc J., Pope, Thomas Lee, Jr, Probyn, Linda J., Rafii, Mahvash, Rankine, James J., Rao, Nisha, Rao, Vijay M., Rider, Lisa Georgianne, Roberts, Catherine C., Rogers, Lee F., Rolón, Alejandro U., Rosenberg, Zehava Sadka, Rosenbloom, Lorne, Rosenthal, Daniel, Rubin, David A., Salgado, Rodrigo A., Schenk, Barry, Scheurecker, Anna, Schils, Jean, Schorn, Corinna, Schweitzer, Mark E., Sekiya, Jon K., Shahabpour, Maryam, Shankman, Steven, Smith, Roger, Snoeckx, Annemie, Snyder, Travis G., Som, Peter M., Souillard, Raphaëlle, Sprigg, Alan, Spouge, Alison R.I., Steinbach, Lynne S., Sundaram, Murali, Taljanovic, Mihra S., Teh, James, Tehranzadeh, Jamshid, Tins, Bernhard Johannes, Tshering, Dechen W., Tuite, Michael J., Umans, Hilary, Vande Berg, Bruno C., Vanhoenacker, Filip M., van Rijswijk, Catharina S.P., Verstraete, Koenraad L., Watt, Iain, White, Lawrence M., Williams, Helen J., Willits, Kevin R., Wilson, David John, Yacoub, Emad, Yao, Lawrence, Yu, Joseph S., Zelenko, Natalie, Zlatkin, Michael B., and Zoga, Adam C.

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22. CONTRIBUTORS

Author

Adler, Ronald S., Akeson, Wayne H., Boutin, Robert Downey, Bugbee, William, Chu, Constance R., Chung, Christine B., Coumas, James M., Dalinka, Murray K., Dwek, Jerry R., Fallon, Michael D., Feldman, Frieda, Garfin, Steven R., Goergen, Thomas G., Goldman, Amy Beth, Greenway, Guerdon D., Guilford, W. Bonner, Haghighi, Parviz, Haygood, Tamara Miner, Herman, Thomas E., Howard, Brian A., Kaplan, Phoebe A., Kyriakos, Michael, Mack, Laurence A., Madewell, John E., Manolagas, Stavros C., McAlister, William H., Murphy, William A., Jr., Ozonoff, M.B., Pathria, Mini N., Pitt, Michael J., Ross, Jeffrey S., Rubin, David A., Sartoris, David J., Scheible, F. William, Schneider, Robert, Sofka, Carolyn M., Sweet, Donald E., and Weissman, Barbara N.

23. Contributor List

Author

Boutin, Robert Downey, Delgado, Gonzalo, Disler, David G., Greenway, Guerdon D., Madewell, John E., Pathria, Mini N., Recht, Michael P., Rubin, David A., and Sweet, Donald E.

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24. The prevalence of fracture extension in displaced femoral neck fractures in the elderly: A pilot study.

Author

Natsuhara KM, Boutin RD, Lee MA, and Meehan JP

Abstract

Objective: Arthroplasty is the common treatment for intracapsular femoral neck fractures in the elderly. Recent studies have shown that there may be more overall complications related to uncemented hemiarthroplasty compared to cemented, including more subsidence, intraoperative fractures, and postoperative fractures. Uncemented femoral components rely on a press fit, and the risk of these complications would be expected to increase in patients with unrecognized distal extension of femoral neck fractures. The purpose of this study is to determine the frequency of fracture extension of displaced femoral neck fractures in the elderly population., Methods: The electronic medical record database at our institution was retrospectively reviewed to search for consecutive reports from 2005 to 2015 of patients 65 years or older that sustained an intracapsular femoral neck fracture who had computed tomography (CT) examinations of the injury. Exclusion criteria were CTs that were not fine cut (<1.5 mm cuts) or occult femoral neck fractures that were seen only on magnetic resonance imaging. This resulted in 60 patients that were included in the study. Within this subset of patients, the CT scans were reassessed to look for extension of the fracture beyond the boundaries of the femoral neck. Of particular interest, were fracture lines that extended distal to the femoral neck, since these have the potential to affect the fit of an uncemented femoral stem. Data on subject age, gender, body mass index (BMI), and bone mineral density (BMD) were also collected, and it was determined if these demographics were predictive in patients having fracture extension. Treatment and follow-up data were collected for the patients as well., Results: Seven of 60 patients were identified to have fracture extension of intracapsular femoral neck fractures. The frequency of fracture extension of intracapsular femoral neck fractures distal to the femoral neck was 8.3% (5/60). All cases of fracture extension were nondisplaced or minimally displaced. 60% (3/5) of the distal fracture extensions were not diagnosed preoperatively by the radiologists or the treating orthopaedic surgeons. There was not a statistically significant difference when comparing age, gender, BMI, or BMD of the population group with distal fracture extension to that of the rest of the patient cohort., Conclusions: To our knowledge, this is the first study to report the frequency of fracture extension of displaced femoral neck fractures in the elderly population. The 8.3% rate of distal fracture extension in elderly femoral neck fractures may help explain the higher rate of subsidence, postoperative fracture and intraoperative fracture when applying uncemented hemiarthroplasty compared to cemented arthroplasty. It is important to be aware of the potential for this phenomenon., Competing Interests: Conflicts of Interest and Source of Funding: The authors have no sources of funding and conflicts of interest to disclose., (Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)

Published
2019
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