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Asian patients with osteoporosis suffer from an increased incidence of hip fracture and a potentially increased risk of fixation failure due to anatomical differences compared to Caucasians.
While we have had success using single interlock screws both proximal and distal for rotational osteotomies in miserable malalignment patients, we have found that SCFE patients (more often male and larger) are at an increased risk of fixation failure [26].
Arthroplasty surgery eliminates the risk of fixation failure as the femoral head is replaced.
Despite these biomechanical findings, very few clinical studies have reported an association between osteoporosis and an increased risk of fixation failure [ 10, 11].
The first aspect seems logical since current osteoporosis diagnostic tools were developed only to predict an overall fracture risk and not the local risk of fixation failure.
The focus of this article is to describe a protocol that was designed to examine a hypothesised association between local bone quality and the risk of fixation failure.
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Smoking has not been included as a factor because it increases general surgical risk, independent of fixation technique.
The objective of this prospective multicenter study was to assess the risk of fracture fixation complications (FFCs), the occurrence of mismatch and the quality of life status of patients treated with the PFNA-II.
However, the application of a conventional rigid skull-fixed navigation star for accurate registration is limited for use in the paediatric population, because of the risk of unstable fixation, dural perforation, and intracranial bleeding.
Biomechanical tests have demonstrated the potential role of osteoporosis in the increased risk of fracture fixation complications, yet this has not been sufficiently proven in clinical practice.
This is the main reason for the absence of a universal classification system defining complications and thereby, a lack of clinical correlation between osteoporosis and the risk of fracture fixation failure.
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