Ideal screw positions for multiple screw fixation in femoral neck fractures – Study of proximal femur morphology in a Japanese population

2018 ◽  
Vol 23 (3) ◽  
pp. 521-524 ◽  
Author(s):  
Yuta Nakanishi ◽  
Takafumi Hiranaka ◽  
Masahiro Shirahama ◽  
Masafumi Uesugi ◽  
Kenjiro Okimura ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Japanese Population ◽  
Screw Fixation ◽  
Femoral Neck Fractures

scholarly journals Femoral neck fractures in osteogenesis imperfecta patients: A retrospective case series and novel surgical technique

2017 ◽  
Vol 3 (3) ◽  
pp. 14
Author(s):  
Mark T. Gorsche ◽  
Michelle S. Caird ◽  
Frances A. Farley ◽  
G. Ying Li ◽  
Matthew D. Abbott
Keyword(s):  
Femoral Neck ◽  
Osteogenesis Imperfecta ◽  
Proximal Femur ◽  
Screw Fixation ◽  
Case Series ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Coxa Vara ◽  
Retrospective Case ◽  
Revision Procedure

Case: We conducted a retrospective review of three cases of femoral neck fractures treated operatively in patients with osteogenesis imperfecta (OI). All of our patients had acetabular protrusio as well as coxa vara deformity. All patients successfully underwent cannulated screw fixation without avascular necrosis (AVN). One patient required a sub-adductor hip arthrogram during a revision procedure to assist with visualization of the proximal femur which resulted in improved screw purchase.Conclusions: We report on three cases of femoral neck fractures in OI patients and a previously undescribed technique; using a hip arthrogram to assist in fluoroscopic evaluation of the proximal femur in these osteopenic patients.

scholarly journals Cancellous Screw Fixation for Undisplaced Femoral Neck Fractures in the Elderly

2014 ◽  
Vol 22 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Ruben Manohara ◽  
Shen Liang ◽  
Deborah Huang ◽  
Lingaraj Krishna
Keyword(s):  
Femoral Neck ◽  
Screw Fixation ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Cancellous Screw

Finite element analysis of the impact of screw insertion distal to the trochanter minor on the risk of iatrogenic subtrochanteric fracture

2018 ◽  
Vol 232 (8) ◽  
pp. 807-818 ◽  
Author(s):  
Ersin Sensoz ◽  
Fatih Mehmet Özkal ◽  
Volkan Acar ◽  
Ferit Cakir
Keyword(s):  
Finite Element ◽  
Femoral Neck ◽  
Screw Fixation ◽  
Subtrochanteric Fracture ◽  
Femoral Neck Fractures ◽  
Cannulated Screws ◽  
Screw Insertion ◽  
Subtrochanteric Fractures ◽  
Trochanter Minor ◽  
The Impact

Iatrogenic subtrochanteric fractures are rarely encountered after cannulated screw fixation of femoral neck fractures; however, when they do occur, there can be several complications. Many orthopedic surgeons have concerns about the potential for iatrogenic subtrochanteric fractures after screw fixation distal to the trochanter minor; therefore, some surgeons are typically reluctant to perform this procedure. This study focused on the risk of an iatrogenic subtrochanteric fracture after treating femoral neck fractures with cannulated screws. The main purpose of the study was to understand iatrogenic subtrochanteric fractures and evaluate the effects on these fractures of an inverted triangular–shaped configuration for placement of the cannulated screws. A femur bone with an femoral neck fracture at a 40° incline to the horizontal plane was generated along with a representation of a three-dimensional finite element model, and three inverted triangular–shaped configurations for placement of the cannulated screws were investigated using finite element analyses. Statistical results indicated that the occurrence risk of ISF increases when the screw is located distal to the trochanter minor. Moreover, the risk of occurrence of intertrochanteric fracture increases when the screw is located medial to the trochanter minor because of local concentrated stress on the surface of the screw canals. To avoid the vulnerability of the subtrochanteric region, it was found that proximal placement of the screws using the inverted triangular–shaped configuration could yield better results. In addition, the results of this study provide suggestions on improved screw configurations.

scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

scholarly journals Calcar buttressed screw fixation for femoral neck fracture

2018 ◽  
Vol 5 (1) ◽  
pp. 145
Author(s):  
K. K. Arvind Manoj ◽  
R. Karthik ◽  
A. Vishnu Sankar
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Screw Fixation ◽  
Femoral Neck Fractures ◽  
Fixation Strength ◽  
Harris Hip Score ◽  
Average Period ◽  
Excellent Outcome ◽  
Neck Fracture

<p class="abstract"><strong>Background:</strong> The incidence of neck of femur fracture among elderly population is increasing day by day. Femoral neck fracture has always been an unsolved fracture<strong> </strong>as far as treatment and results are concerned. There are different views regarding the optimal method of internal fixation in femoral neck fractures. Biomechanical data from literature suggest that calcar fixation is superior to central screws placement. This study aims to analyse the functional and radiological outcome of femoral neck fractures treated by calcar buttressed screw fixation described by Filipov as biplane double supported screw fixation.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from May 2015 to May 2018.The study included 43 patients (31 male, 12 female) with femoral neck fracture. Three 6.5-mm cannulated screws were laid in two medially diverging oblique planes. The distal and the middle screws were supported on the calcar. The distal screw had additional support on the posterior neck cortex. Patients were followed up for average period of 2 years. Functional outcome was evaluated using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Bone union occurred in 40 patients (93%) with average period of 3-4 months.<strong> </strong>51.2% of cases had<strong> </strong>excellent outcome. 23.2% of cases had good and 16.3% of cases had fair outcome. 9.3% of cases ended with poor outcome. Non union was reported in 3 patients (7%) and AVN in one patient. Various factors like age, Garden and Pauwel fracture types, time of presentation and time of surgery were statistically significant to the final functional outcome in our study.</p><p><strong>Conclusions:</strong> By providing additional calcar buttress compared to conventional method, this technique of screw fixation enhances femoral neck fracture fixation strength and reduces the fixation failure. </p>

scholarly journals Closed Reduction And Cannulated Screw Fixation For Pediatric Femoral Neck Fractures: A Case Series

2021 ◽  
Author(s):  
Hakan Cici ◽  
Sabahaddin Kiliç
Keyword(s):  
Femoral Neck ◽  
Closed Reduction ◽  
Screw Fixation ◽  
Case Series ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Fixation Method ◽  
Coxa Vara

Objective: Pediatric femoral neck fractures are uncommon injuries. Accurate early reduction and fixation is recommended to avoid serious long-term complications. The aim of this study was to analyze the clinical and radiological outcomes of 12 children with femoral neck fractures who were treated with closed reduction and cannulated screw fixation. Method: Between November 2015 and December 2019, 12 children (4 males,8 females) with an average age of 9.7 were operated by closed reduction and cannulated screw fixation for femoral neck fractures. We evaluated the medical records of all patients, including age, gender, injury mechanism, fracture type, initial displacement, postoperative reduction, follow-up roentgenograms and Ratliff’s scores. Results: The mean follow-up was 22.3 months (range 12–47 months). Six Delbett type 2, five Delbett type 3 and one Delbett type 4 fractures were operated with an avarage time to surgery of 12.5 (range: 1-75 hours). Satisfactory outcomes according to Ratliff’s criteria were obtained in 10 (%83.3) children. Coxa vara occurred in 2 cases. Any avascular necrosis was not seen during the follow-up period. Conclusion: Early closed reduction and cannulated screw fixation may be effective to avoid long-term complications in pediatric femoral neck fractures. Keywords: Femoral neck fracture, Pediatric, Closed reduction

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