Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: A postoperative gait analysis

Injury ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1324-1328 ◽  
Author(s):  
Daniel Pfeufer ◽  
Chiara Grabmann ◽  
Stefan Mehaffey ◽  
Alexander Keppler ◽  
Wolfgang Böcker ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Gait Analysis ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Pertrochanteric Fractures

POSTOPERATIVE GAIT ANALYSIS FOLLOWING FEMORAL NECK FRACTURES TREATED WITH ENDOPROSTHESIS

1990 ◽  
Vol 83 (Supplement) ◽  
pp. 2S-48
Author(s):  
John A. Michalski ◽  
Robert Liebenberg ◽  
Albert Esquenazi ◽  
Donald Talenti
Keyword(s):  
Femoral Neck ◽  
Gait Analysis ◽  
Femoral Neck Fractures

scholarly journals A study of prospective analysis of unipolar versus bipolar hemiarthroplasty of hip joint in patients with fracture neck of femur

2021 ◽  
Vol 7 (3) ◽  
pp. 629
Author(s):  
Raja X. ◽  
Arjun Sarvesh ◽  
Karthikeyen M. ◽  
A. E. Manoharan
Keyword(s):  
Femoral Neck ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Early Weight Bearing ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP.</p><p class="abstract"><strong>Results:</strong> Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA).</p><p class="abstract"><strong>Conclusions:</strong> Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.</p>

scholarly journals Cementless Stem for Femoral Neck Fractures in a Patient’s 10th Decade of Life: High Rate of Periprosthetic Fractures

2018 ◽  
Vol 9 ◽  
pp. 215145931876538 ◽  
Author(s):  
Method Kabelitz ◽  
Yannick Fritz ◽  
Patrick Grueninger ◽  
Christoph Meier ◽  
Patrick Fries ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Periprosthetic Fractures ◽  
Full Weight Bearing ◽  
Morbidity Rate ◽  
Old Patients ◽  
Invasive Approach ◽  
Very Old ◽  
Very Old Patients

Background: Subsidence of cementless femoral stems in hemiarthroplasty (HA) and increased fracture rates are ongoing concerns of orthopedic surgeons when treating fractures in very old patients. Additionally, bone cement implantation syndrome may result in perioperative cardiac or pulmonary complications, especially in older patients, leading to morbidity and mortality. This study was performed to analyze possible subsidence and intraoperative fractures in a cohort of very old patients treated with cementless stems. Methods: We retrospectively analyzed a consecutive cohort of patients aged ≥90 years with femoral neck fractures treated by uncemented HA and an anterior minimally invasive approach. Immediate full-weight bearing was allowed postoperatively. Pelvic radiographs were examined for subsidence immediately postoperatively and 6 weeks later. Results: We treated 109 patients (74% women; mean age, 93 years; range, 90-102 years) by HA from January 2010 to March 2016. The 30-day mortality rate was 16%, and the morbidity rate was 47%. There were 11 (12%) intraoperative fractures: 8 (Vancouver B2) had to be addressed immediately during the primary operation, while 3 (1 Vancouver B1 and 2 Vancouver AG) were treated conservatively. One periprosthetic femoral fracture (Vancouver B1) was documented during follow-up. In 17 patients, subsidence of >2.0 mm (median, 3.9 mm; range, 2.5-9.0 mm) was documented. Conclusion: Early subsidence was low in this very old cohort treated with an uncemented stem and not showing a periprosthetic fracture. The risk of intraoperative periprosthetic fractures was high. The use of uncemented implants in osteoporotic bone continues to be an intervention with high risk and should only be performed by experienced surgeons. Level of Evidence: Level III, Therapeutic study.

scholarly journals Short-Term Clinical Efficacy of Femoral Neck System Versus Multiple Cannulated Compression Screws in the Treatment of Garden III and IV Femoral Neck Fractures

2022 ◽  
Author(s):  
Xuefeng Zhou ◽  
Sichao Gu ◽  
Li Li ◽  
Lei Xu ◽  
Xujin Wang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Clinical Efficacy ◽  
Weight Bearing ◽  
Operation Time ◽  
Femoral Neck Fractures ◽  
Teaching Hospitals ◽  
Harris Hip Score ◽  
Clinical Report ◽  
Short Term

Abstract Femoral neck system (FNS) , as a novel minimally invasive internal fixation device, has been gradually applied in the treatment of femoral neck fracture.However, there are few related clinical studies on FNS at present, especially there is no clinical report on FNS in treating GardenIII and IV femoral neck fractures. The aim of the present study was to compare the short-term clinical efficacy of FNS and multiple cannulated compression screws (MCCS) in the treatment of Garden III and IV femoral neck fractures. The data of 78 patients with femoral neck fracture who were admitted to three teaching hospitals affiliated to Anhui Medical University and received internal fixation with FNS and MCCS from June 2019 to December 2020 were collected for a retrospective study. There were 39 patients in both the FNS and MCCS groups. The basic data, perioperative data were recorded and compared between the two groups of patients. The results of the study are encouraging. The operation time was shorter in FNS group than that in MCCS group (p<0.001). The post-operative partial and complete weight-bearing time was earlier in FNS group than that in MCCS group (p<0.001). The Harris hip score in FNS group was higher than that in MCCS group (p<0.001). The incidence rate of lateral thigh irritation in FNS group and MCCS group was 0 (0/39) and 33.3% (13/39), respectively (χ2=15.600, p<0.001). The length of femoral neck shortening was significantly shorter in FNS group than that in MCCS group (t=-5.093, p<0.001). In conclusion, The application of FNS for Garden III and IV femoral neck fractures can shorten the operation time, reduce the frequency of intraoperative fluoroscopy, and facilitate the recovery of hip joint function, so it provides a novel choice for the treatment of Garden III and IV femoral neck fractures in young people.

scholarly journals Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study

2020 ◽  
Author(s):  
Ya-Ping Xiao ◽  
Ming-Jian Bei ◽  
Tao Ji ◽  
Yong-Jun Peng ◽  
Bing Ma ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Fracture Healing ◽  
Healing Rate ◽  
Dynamic Compression ◽  
Weight Bearing ◽  
Operation Time ◽  
Healing Time ◽  
Femoral Neck Fractures ◽  
Incision Length ◽  
Harris Score

Abstract Background: Femoral neck fractures are one of the problems in orthopedic treatment. The prognosis is uncertain. Currently, there is no one internal fixation for the treatment of femoral neck fractures that shows superiority over other internal fixations. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic compression locking system （DCLS）and multiple cannulated compression screws（MCCS） in the treatment of femoral neck fractures.Methods: A prospective analysis of 54 cases of femoral neck fractures treated with either a DCLS (n=28) or MCCS (n=26) was conducted between December 2015 and November 2017 in authors’ hospitals. The perioperative and postoperative parameters of the two groups were recorded and evaluated.Results: Fifty-four patients were followed up for 24-47 months. The etiology was caused by a fall. There was no significant difference in follow-up time, operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the two groups (P> 0.05). The Harris score, fracture healing time, femoral neck shortening, partial weight-bearing time and complete weight-bearing time were significantly better in the DCLS group than in the MCCS group (P< 0.05). The fracture healing rate in the DCLS group was higher than that in the MCCS group.Conclusion: The DCLS and MCCS might be equally effective in terms of operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the treatment of femoral neck fractures. However, the DCLS is superior to the MCCS in Harris score, fracture healing time, femoral neck shortening, weight-bearing time and fracture healing rate. So, DCLS deserves further study.

Comparison of Bone Mineral Density at Hip and Lumbar Spine in Patients with Femoral Neck Fractures and Pertrochanteric Fractures

2021 ◽  
Vol 23 (1) ◽  
pp. 45-49
Author(s):  
Chulin Chewakidakarn ◽  
Varah Yuenyongviwat
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Dual Energy ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
Mineral Density ◽  
Pertrochanteric Fractures ◽  
X Ray ◽  
Total Hip

Background. Geriatric hip fractures, including femoral neck and pertrochanteric fractures, are common nowadays, which is related to increasing numbers of elderly people worldwide. Osteoporosis is an important risk factor associated with hip fractures. This study aimed to describe the association of hip fractures and osteoporosis at different BMD measurement sites and determine any differences between these two types of hip fracture. Material and methods. A retrospective study conducted in a university hospital in the south of Thailand enrolled 223 patients aged over 50 years with low-energy trauma hip fractures. Each patient had undergone dual energy x-ray absorptiometry (DXA) within 2 weeks of injury. T-scores were recorded for the total hip, femoral neck and lumbar spine areas and classified as normal, osteopenia and osteoporosis according to WHO osteoporosis diagnostic criteria. Results. The highest proportion of T-scores in the osteoporotic range were registered at the femoral neck (68.6%) compared to total hip (52.9%) and lumbar spine (47.7%). At least 31.4% of patients were in the non-osteoporotic range. No significant differences were found at all sites of BMD measurement between the two types of fracture. Conclusions. 1. At least 1/3 of patients with geriatric hip fractures had their T-scores in the normal to oste­ope­nic range. 2. BMD in different areas is not different between types of hip fractures.

scholarly journals Surgical Treatment of Femoral Neck Fractures with Dynamic Derotation Оsteosynthesis

2016 ◽  
Vol 23 (4) ◽  
pp. 5-11
Author(s):  
V. E Dubrov ◽  
A. V Yudin ◽  
I. M Shcherbakov ◽  
A. O Ragozin ◽  
A. L Matveev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
The Body ◽  
High Rate ◽  
Control Group ◽  
Treatment Results ◽  
Bone Implant ◽  
Clinical Observations ◽  
Implant System

Fracture of the femoral neck is a common injury of the human skeleton. High rate of postoperative complications induces to the search of optimum osteosynthesis technique. Treatment results for 259 patients (182 females, 77 males, mean age 72 years) with femoral neck fractures were analyzed. In study group (n=114) a dynamic derotation osteosyntesis and in control group (n=145) - DHS, a bundle of V-shaped curved pins, cannulated screws were used. Mathematic modelling of bone-implant system in different variants of derotation fixator screws position under load was performed. Use of dynamic derotation constructions in Garden 1 and Garden 2 femoral neck fractures ensured a consolidation of fractures in all clinical observations, in Garden 3 fractures - in 46.4%. Early dosage weight bearing not exceeding 60% of the body weight did not result in either fragments displacement or raise of the rate of femoral head avascular necrosis development. In patients under 60 years it is preferably to use dynamic derotation constructions with 4 screws placed in the femoral neck.

scholarly journals Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Zhu ◽  
Hongzhi Hu ◽  
Xiangtian Deng ◽  
Yiran Zhang ◽  
Xiaodong Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Calibration Curve ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Abstract Objective We aimed to evaluate risk factors and develop a nomogram for reoperation after internal fixation of nondisplaced femoral neck fractures (FNFs) in elderly patients. Methods We conducted a retrospective study involving a total of 255 elderly patients who underwent closed reduction and internal fixation with cannulated screw system for nondisplaced FNFs between January 2016 and January 2019. We collected data on demographics, preoperative radiological parameters, surgery, serum biochemical markers, and postoperative rehabilitation. In addition, we performed univariate and multivariate logistic regression analyses to determine independent risk factors for reoperation, and then developed a nomogram to assess the risks of reoperation. Besides, discriminative ability, calibration, and clinical usefulness of the nomogram were evaluated using the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. We employed bootstrap method to validate the performance of the developed nomogram. Results Our analysis showed that among the 255 patients, 28 (11.0%) underwent reoperation due to osteonecrosis of the femoral head (14 cases), mechanical failure (8 cases) or nonunion (6 cases). All of the 28 patients underwent conversion surgery to arthroplasty. The multivariate logistic regression analysis demonstrated that preoperative posterior tilt angle ≥ 20°, Pauwel’s III type, younger patients, preoperative elevated levels of alkaline phosphatase (ALP), preoperative hypoalbuminemia, and early postoperative weight-bearing were independent risk factors for reoperation. In addition, the C-index and the bootstrap value of the developed nomogram was 0.850 (95% CI = 0.803–0.913) and 0.811, respectively. Besides, the calibration curve showed good consistency between the actual diagnosed reoperation and the predicted probability, while the DCA indicated that the nomogram was clinically valuable. Conclusions Our analysis showed we successfully developed and validated a nomogram for personalized prediction of reoperation after internal fixation of nondisplaced FNFs in elderly patients. This model would help in individualized evaluation of the need for reoperation and inform strategies aimed at eliminating the need for the reoperation.

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