{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:58:54Z","timestamp":1773021534909,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["62376159"],"award-info":[{"award-number":["62376159"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12172224"],"award-info":[{"award-number":["12172224"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Posteriorly tilted femoral neck fractures have been extensively studied, whereas anteriorly tilted fractures remain largely unreported. This study aims to characterize the clinical features, radiographic patterns, and postoperative outcomes of femoral neck fractures with anterior tilt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included adult patients with OTA\/AO type 31B femoral neck fractures who underwent internal fixation within 36\u2009h at a single orthopedic center from 2018 to 2022 and had \u2265\u200924\u2009months of follow\u2010up. Tilt angle was assessed using preoperative radiographs and CT. Associations between fracture characteristics and postoperative outcomes were examined using univariate and multivariable logistic regression, with covariates selected according to clinical relevance and univariate significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 212 patients (median age: 55\u2009years, 53.3% male), anterior tilt fractures were more common in females (57.6%) and those with valgus malalignment (69.7%). Anteriorly tilted femoral neck fractures required a distinct reduction technique compared to conventional femoral neck fractures. Displaced fractures were significantly associated with a higher risk of femoral head necrosis (adjusted odds ratio [aOR]\u2009=\u20094.16; 95% confidence interval [CI] 1.29\u201313.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). Stratified analysis revealed that anteriorly tilted femoral neck fractures with varus malalignment\u2014herein referred to as the \u201canterior\u2010flexion\/adduction\u201d subtype\u2014were significantly associated with increased risk of femoral head necrosis (aOR\u2009=\u20097.19; 95% CI 1.12\u201346.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anterior tilt alone is not a general prognostic risk factor; however, fractures characterized by anterior tilt combined with varus alignment represent a high\u2010risk subtype requiring careful preoperative recognition and treatment planning. Further prospective studies are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70257","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T04:38:45Z","timestamp":1770179925000},"page":"558-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Femoral Neck Fracture With Anterior Tilt"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3842-7942","authenticated-orcid":false,"given":"Yu\u2010Kai","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming\u2010Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Guizhou Aerospace Hospital Zunyi Medical University  Zunyi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng\u2010Hui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Fujian Medical University Union Hospital  Fujian China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Guizhou Aerospace Hospital Zunyi Medical University  Zunyi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Guizhou Aerospace Hospital Zunyi Medical University  Zunyi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-5694","authenticated-orcid":false,"given":"Jiong","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-024-05553-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-23-01121"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-57696-2"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-2990-5"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.5371\/hp.2023.35.4.259"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-016-1746-2"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2016.1155253"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.09.033"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2022.106958"},{"issue":"3","key":"e_1_2_13_11_1","first-page":"273","article-title":"Review of Closed Reduction Techniques for Femoral Neck Fracture","volume":"36","author":"Zhu X.","year":"2022","journal-title":"China Journal of Orthopaedics and Traumatology"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04703-w"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000002355"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-015-9278-7"},{"key":"e_1_2_13_15_1","first-page":"647","article-title":"Low\u2010Angle Fixation in Fractures of the Femoral Neck","volume":"43","author":"Garden R. 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