Medial repair band: independent risk factor for collapse in traumatic osteonecrosis of the femoral head
- 1Quanzhou Orthopedic Clinical Medical College, Fujian University of Traditional Chinese Medicine, Quanzhou, Fujian, China
- 2Department of Orthopaedic Surgery, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
- 3Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
Abstract
ObjectiveFemoral head collapse is closely associated with a poor prognosis in osteonecrosis of the femoral head (ONFH). This study aimed to evaluate the association between the MRI repair band and the progression to collapse in traumatic osteonecrosis of the femoral head (TONFH).MethodsWe retrospectively analyzed TONFH patients admitted from January 2016 to May 2023. The following clinical data were collected: patient age, sex, affected side, presence of complete fracture displacement, performance of emergency surgery, achievement of anatomical reduction, and other relevant clinical characteristics. Median follow-up was 44.5 months, with collapse >2 mm as the survival endpoint. Univariate and multivariate regression analyses assessed the association between MRI medial repair band and collapse. Inter-observer consistency was evaluated using Kappa test. We also analyzed the association between fracture displacement and MRI medial repair band.Results148 TONFH patients were included [median age 46.50 years (IQR: 38.50–52.00); 67(45.27%) males, 81(54.73%) females]. Collapse occurred in 63 (collapse group) vs. 85 (non-collapse group). The interobserver reliability of the medial repair zone, as measured by the intraclass correlation coefficient (ICC), was 0.802.Multivariate analysis identified the medial repair band as an independent risk factor for collapse (OR: 13.350, 95% CI: 5.767–30.907; P < 0.001). Survival was significantly lower with a medial vs. lateral repair band (P < 0.001). Garden type IV fracture was significantly associated with medial repair band formation (OR: 2.581, 95% CI: 1.304–5.106; P = 0.006).ConclusionThe medial repair band on MRI is an independent risk factor for collapse in patients with TONFH; furthermore, Garden type IV is closely associated with the formation of the medial repair band. The MRI medial repair band is an imaging feature for assessing the risk of collapse in TONFH.
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BibTeX
@article{wang2026medial,
title = {{Medial repair band: independent risk factor for collapse in traumatic osteonecrosis of the femoral head}},
author = {Yanyu Wang and Yanyu Wang and Changyu Huang and Zhibing Gong and Ziqi Li and Wei He and Zhaoke Wu and Zhikun Zhuang and Zhikun Zhuang},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.2001241},
url = {https://doi.org/10.3389/fmed.2026.2001241},
note = {CC BY},
}
RIS
TY - JOUR
TI - Medial repair band: independent risk factor for collapse in traumatic osteonecrosis of the femoral head
AU - Yanyu Wang
AU - Yanyu Wang
AU - Changyu Huang
AU - Zhibing Gong
AU - Ziqi Li
AU - Wei He
AU - Zhaoke Wu
AU - Zhikun Zhuang
AU - Zhikun Zhuang
PY - 2026
DA - 2026/10/26
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.2001241
UR - https://doi.org/10.3389/fmed.2026.2001241
AB - ObjectiveFemoral head collapse is closely associated with a poor prognosis in osteonecrosis of the femoral head (ONFH). This study aimed to evaluate the association between the MRI repair band and the progression to collapse in traumatic osteonecrosis of the femoral head (TONFH).MethodsWe retrospectively analyzed TONFH patients admitted from January 2016 to May 2023. The following clinical data were collected: patient age, sex, affected side, presence of complete fracture displacement, performance of emergency surgery, achievement of anatomical reduction, and other relevant clinical characteristics. Median follow-up was 44.5 months, with collapse >2 mm as the survival endpoint. Univariate and multivariate regression analyses assessed the association between MRI medial repair band and collapse. Inter-observer consistency was evaluated using Kappa test. We also analyzed the association between fracture displacement and MRI medial repair band.Results148 TONFH patients were included [median age 46.50 years (IQR: 38.50–52.00); 67(45.27%) males, 81(54.73%) females]. Collapse occurred in 63 (collapse group) vs. 85 (non-collapse group). The interobserver reliability of the medial repair zone, as measured by the intraclass correlation coefficient (ICC), was 0.802.Multivariate analysis identified the medial repair band as an independent risk factor for collapse (OR: 13.350, 95% CI: 5.767–30.907; P < 0.001). Survival was significantly lower with a medial vs. lateral repair band (P < 0.001). Garden type IV fracture was significantly associated with medial repair band formation (OR: 2.581, 95% CI: 1.304–5.106; P = 0.006).ConclusionThe medial repair band on MRI is an independent risk factor for collapse in patients with TONFH; furthermore, Garden type IV is closely associated with the formation of the medial repair band. The MRI medial repair band is an imaging feature for assessing the risk of collapse in TONFH.
SN - 2296-858X
ER -