Comparative Study for Osteosynthesis of Femoral Neck Fractures: Cannulated Screws Versus Femoral Neck System

Overview

Journal Hip Pelvis

Date 2023 Mar 20

PMID 36937213

Authors

Youngho Cho

Jae-Uk Shin

Sangwoo Kim

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures.

Materials And Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated.

Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation.

Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

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References

. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994; 843:1-129. View

Madsen F, Linde F, Andersen E, Birke H, Hvass I, Poulsen T . Fixation of displaced femoral neck fractures. A comparison between sliding screw plate and four cancellous bone screws. Acta Orthop Scand. 1987; 58(3):212-6. DOI: 10.3109/17453678709146468. View

Hsu M, Shu H, Luksameearunothai K, Margalit A, Yu A, Hasenboehler E . Is there an increased risk for subtrochanteric stress fracture with the Femoral Neck System versus multiple cannulated screws fixation?. J Orthop. 2022; 30:127-133. PMC: 8907549. DOI: 10.1016/j.jor.2022.02.016. View

Liporace F, Gaines R, Collinge C, Haidukewych G . Results of internal fixation of Pauwels type-3 vertical femoral neck fractures. J Bone Joint Surg Am. 2008; 90(8):1654-9. DOI: 10.2106/JBJS.G.01353. View

Hu H, Cheng J, Feng M, Gao Z, Wu J, Lu S . Clinical outcome of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patients. J Orthop Surg Res. 2021; 16(1):370. PMC: 8188789. DOI: 10.1186/s13018-021-02517-z. View

Blair B, Koval K, Kummer F, Zuckerman J . Basicervical fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques. Clin Orthop Relat Res. 1994; (306):256-63. View

Corrales L, Morshed S, Bhandari M, Miclau 3rd T . Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am. 2008; 90(9):1862-8. PMC: 2663323. DOI: 10.2106/JBJS.G.01580. View

Stromqvist B, Nilsson L, Thorngren K . Femoral neck fracture fixation with hook-pins. 2-year results and learning curve in 626 prospective cases. Acta Orthop Scand. 1992; 63(3):282-7. DOI: 10.3109/17453679209154783. View

Stappaerts K, Broos P . Internal fixation of femoral neck fractures. A follow-up study of 118 cases. Acta Chir Belg. 1987; 87(4):247-51. View

10.

Zlowodzki M, Wijdicks C, Armitage B, Cole P . Value of washers in internal fixation of femoral neck fractures with cancellous screws: a biomechanical evaluation. J Orthop Trauma. 2014; 29(2):e69-72. DOI: 10.1097/BOT.0000000000000172. View

11.

Nibe Y, Matsumura T, Takahashi T, Kubo T, Matsumoto Y, Takeshita K . A comparison between the femoral neck system and other implants for elderly patients with femoral neck fracture: A preliminary report of a newly developed implant. J Orthop Sci. 2021; 27(4):876-880. DOI: 10.1016/j.jos.2021.04.016. View

12.

Gupta M, Arya R, Kumar S, Jain V, Sinha S, Naik A . Comparative study of multiple cancellous screws versus sliding hip screws in femoral neck fractures of young adults. Chin J Traumatol. 2016; 19(4):209-12. PMC: 4992136. DOI: 10.1016/j.cjtee.2015.11.021. View

13.

Foss N, Kehlet H . Hidden blood loss after surgery for hip fracture. J Bone Joint Surg Br. 2006; 88(8):1053-9. DOI: 10.1302/0301-620X.88B8.17534. View

14.

Crump E, Quacinella M, Deafenbaugh B . Does Screw Location Affect the Risk of Subtrochanteric Femur Fracture After Femoral Neck Fixation? A Biomechanical Study. Clin Orthop Relat Res. 2020; 478(4):770-776. PMC: 7282603. DOI: 10.1097/CORR.0000000000000945. View

15.

Grosso M, Danoff J, Padgett D, Iorio R, Macaulay W . The Cemented Unipolar Prosthesis for the Management of Displaced Femoral Neck Fractures in the Dependent Osteopenic Elderly. J Arthroplasty. 2016; 31(5):1040-6. DOI: 10.1016/j.arth.2015.11.029. View

16.

Stockton D, Lefaivre K, Deakin D, Osterhoff G, Yamada A, Broekhuyse H . Incidence, Magnitude, and Predictors of Shortening in Young Femoral Neck Fractures. J Orthop Trauma. 2015; 29(9):e293-8. DOI: 10.1097/BOT.0000000000000351. View

17.

Pei F, Zhao R, Li F, Chen X, Guo K, Zhu L . Osteonecrosis of femoral head in young patients with femoral neck fracture: a retrospective study of 250 patients followed for average of 7.5 years. J Orthop Surg Res. 2020; 15(1):238. PMC: 7322831. DOI: 10.1186/s13018-020-01724-4. View

18.

Gjertsen J, Vinje T, Engesaeter L, Lie S, Havelin L, Furnes O . Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am. 2010; 92(3):619-28. DOI: 10.2106/JBJS.H.01750. View

19.

Bartonicek J . Pauwels' classification of femoral neck fractures: correct interpretation of the original. J Orthop Trauma. 2001; 15(5):358-60. DOI: 10.1097/00005131-200106000-00009. View

20.

Stoffel K, Zderic I, Gras F, Sommer C, Eberli U, Mueller D . Biomechanical Evaluation of the Femoral Neck System in Unstable Pauwels III Femoral Neck Fractures: A Comparison with the Dynamic Hip Screw and Cannulated Screws. J Orthop Trauma. 2016; 31(3):131-137. DOI: 10.1097/BOT.0000000000000739. View