Management of Intracapsular Femoral Neck Fractures in Adults Younger than 65 Years

2011 ◽  
Vol 15 (2) ◽  
pp. 43-46
Author(s):  
Lo Irene ◽  
Woo Siu-Bon ◽  
Chan Wai-Lam ◽  
Wong Wing-Cheung
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Weight Bearing ◽  
Time Lapse ◽  
Fracture Pattern ◽  
Femoral Neck Fractures ◽  
Initial Stability ◽  
The Mean

Purpose The study is to review the results of intracapsular femoral neck fractures in young adults (age < 65) treated with reduction and multiple-screw fixation from 2000 to 2007. Method Sixty-four consecutive patients were reviewed retrospectively. The mean age of the patients at the time of injury was 53.5 (32–65) years old. All fractures were either closely or openly reduced and fixed with three 7.5-mm cancellous screws. The mean follow up period was 36.8 months (6–100). Results We found that 9 of 64 (14.1%) patients developed osteonecrosis of femoral head on follow up. Displacement of fracture (Garden classification), initial stability of fracture pattern (Pauwel classification), and quality of reduction (Haidukewych grading) were found to have significant effect on the development of osteonecrosis, whereas the effect of patient age, time lapse of surgery, capsulotomy, hip aspiration, and postoperative weight bearing regimen were not statistically significant. Conclusion Fracture pattern and quality of reduction govern the fate of the femoral heads in young adults with their intracapsular femoral neck fractures fixed with screws.

scholarly journals Cemented versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Patients with Neuromuscular Diseases: A Minimum of 2 Years Follow-Up Study

2021 ◽  
Author(s):  
Yuchuan Wang ◽  
Zhongzheng Wang ◽  
Siyu Tian ◽  
Zhanchao Tan ◽  
Yanbin Zhu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Neuromuscular Diseases ◽  
Femoral Neck Fractures ◽  
Intraoperative Blood Loss ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Uncemented Group

Abstract Background The aim of this study is to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between 2015 and 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan-Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 minutes shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

scholarly journals Cemented versus uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular diseases: a minimum of 2 years’ follow-up study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuchuan Wang ◽  
Zhongzheng Wang ◽  
Siyu Tian ◽  
Zhanchao Tan ◽  
Yanbin Zhu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Neuromuscular Diseases ◽  
Femoral Neck Fractures ◽  
Intraoperative Blood Loss ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Uncemented Group

Abstract Background The aim of this study was to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between June 2015 and December 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan–Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 min. shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS, and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

scholarly journals Follow-up Study of Femoral Neck Fractures in Young Adults.

1995 ◽  
Vol 44 (4) ◽  
pp. 1323-1325
Author(s):  
Hiroshi Baba ◽  
Ryuzo Majima ◽  
Toshiyuki Tsurumoto ◽  
Akihiko Yonekura
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Follow Up Study

The Long-Term Results of Lubinus Interplanta Hemiarthroplasty in 228 Acute Femoral Neck Fractures. A Retrospective Six-Year Follow-Up

2002 ◽  
Vol 91 (4) ◽  
pp. 357-360 ◽  
Author(s):  
K. Isotalo ◽  
J. Rantanen ◽  
V. Äärimaa ◽  
E. Gullichsen
Keyword(s):  
Survival Analysis ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Long Term Results ◽  
Dislocation Rate ◽  
Kaplan Meier ◽  
The Mean

Background and Aims: We retrospectively studied survival of patients treated with Lubinus interplanta (IP) semiendoprosthesis in acute hip fracture. Materials and Methods: The long-term results of Lubinus interplanta (IP) hemiarthroplasty in 228 acute medial fractures of the femoral neck in 222 patients were reviewed. Results and Conclusions: The mean age of the patients was 80.3 years. The mean duration of post-operative follow-up was 6.3 years (range 5–8 years). There were 12 reoperations (5.3 %), of which 8 were revisions (3.5 %). Dislocation rate was 3.5 %. Survival was 93 % at three years and 88 % at six years (Kaplan-Meier-survival analysis). Conclusions: These results surpass those previously published after Thompson and Moore hemiarthroplasties. The Lubinus prosthesis has a greater CCD (caput, collum, diaphyse) angle and a longer stem compared to Thompson and Moore implants. The need for resection of calcar cortex is also limited. These biomechanical facts may explain the good long-term results of Lubinus hemiarthroplasty.

scholarly journals Decreased complications but a distinctive fixation loosening mechanism of fully threaded headless cannulated screw fixation for femoral neck fractures in young adults

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hui Sun ◽  
Lin-Yuan Shu ◽  
Matthew C. Sherrier ◽  
Yi Zhu ◽  
Jing-Wen Liu ◽  
...  
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Young Patients ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Low Energy ◽  
Cannulated Screws ◽  
Fixation Failure ◽  
Fracture Patterns

Abstract Background Despite being a commonly encountered injury in orthopedic practice, controversy surrounds the methods of optimal internal fixation for femoral neck fractures (FNF) in young patients. The objective of the present study is to compare complication rates and failure mechanisms for surgical fixation of FNF using fully threaded headless cannulated screws (FTHCS) versus partial threaded cannulated screws (PTS) in young adults. Methods A total of 75 patients (18–65 years old) with FNF were prospectively treated with close reduction and internal fixation using three parallel FTHCS and compared to a historical control case-matched group (75 patients) with FNF treated by PTS fixation. After 2 years follow-up, rates of fixation failure (including varus collapse, fracture displacement, and femoral neck shortening), nonunion, and avascular necrosis of the femoral head (ANFH) were compared between the two cohorts. The demographic, follow-up information, and radiological images were assessed by independent blinded investigators. Results Patient demographics and fracture patterns were similar in the two patient groups. The overall fixation failure rates were 8% (6/75) in the FTHCS cohort, which was significantly lower than the 25.3% (19/75) seen in the PTS group. Rates of nonunion and ANFH were significantly lower in the FTHCS group when compared to the PTS control group. When stratified by injury severity (high-energy vs. low-energy fractures), the rate of fixation failure was significant lower with the use of FTHCS when compared with PTS for high-energy fractures while there was no difference in the rates of nonunion or ANFH for high or low-energy fracture patterns. Unique to the FTHCS cohort was an atypical screw migration pattern with varus collapse (6/75, 8%). Conclusions The results show that FTHCS fixation could significantly reduce the complication rate of young patients with FNF, especially in high-energy fracture patterns (Garden III–IV, Pauwels III, or vertical of the neck axis (VN) angle ≥ 15°). There was also confirmation that the modes of fixation loosening in the FTCHS group, including screw “medial migration” and superior cutout, were different from the screw withdrawal pattern seen in the PTS cohort. Trial registration The study was retrospectively registered at www.Chictr.org.cn (ChiCTR-IPR-1900025851) on September 11, 2019.

scholarly journals Clinical results of cannulated screw internal fixation via direct anterior approach for femoral neck fractures in young adults: a retrospective study

2020 ◽  
Author(s):  
Yi Yuan ◽  
Rui Huang ◽  
Jia-fu Yang ◽  
Fa-dong Li ◽  
zu-jian xu ◽  
...  
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Open Reduction ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Direct Anterior Approach ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Harris Score

Abstract Purpose: To investigate the effectiveness of open reduction and cannulated screw fixation via direct anterior approach (DAA) for the treatment of femoral neck fractures in young adults. Methods: The data from 43 young patients with irreducible femoral neck fractures who underwent this procedure from January 2013 to December 2017 were retrospectively analyzed. Garden's alignment index was measured after the operation and at the final follow-up to determine the reduction quality, and the Harris score was recorded at the final follow-up to assess hip function. Results: The average follow-up duration was 19 months (range, 12-31 months). Implant failure was observed in 3 cases and was associated with femoral neck shortening, and nonunion occurred in 2 patients. A total of 6 patients Exhibited features of avascular necrosis (AVN), four of whom (Ficat grade III) underwent total hip arthroplasty and two of whom (Ficat grade II) were asymptomatic at the final follow-up. There were no statistically significant differences in Garden's alignment index, as measured on X-ray radiographs, immediately after surgery and at the final follow-up. At the final follow-up, the mean Harris score was 82.41±14.06. The Harris score was considered excellent for 17 cases, good for 13 cases, fair for 3 cases, and poor for 4 cases. The rate of excellent and good outcomes was 81.1%. Conclusions: For cases of irreducible femoral neck fractures, open reduction and cannulated screw fixation via DAA can yield relatively good clinical outcomes.

scholarly journals The Association Between Femoroacetabular Impingement and Internal Fixation of Femoral Neck Fractures

2021 ◽  
Author(s):  
Ali İhsan Kılıç ◽  
Ramadan Özmanevra ◽  
Osman Nuri Eroğlu
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Alpha Angle ◽  
Femoral Neck Fractures ◽  
Acetabular Version ◽  
Unaffected Side ◽  
X Ray ◽  
Neck Fracture ◽  
The Mean

Objective: Congenital deformities, slipped capital femoral epiphysis and Legg-Calve-Perthes disease have been suggested as possible causes for femoroacetabular impingement (FAI). The aim of our study is to describe the radiographic signs of FAI after femoral neck fractures and to compare these data with those of the contralateral hip. Method: Our institutional medical records database was retrospectively searched for patients 18-50 years old with a history of femoral neck fractures (OTA 31-B) between 2010-2019. Fifty-two patients were identified. After exclusion criteria, we detected 37 fractures in 37 patients. The mean age of 29 male and 8 female patients was 32,7 (range 18-48) years. The antero-posterior and cross- table lateral views of bilateral hip joints for all 37 patients were reviewed preoperatively and at final follow-up. The mean follow-up period was 48 months (range 6-98 months). In addition, postoperative CT-scans of these patients were also reviewed. Results: According to OTA classification subtypes, 2 subcapital (31B1), 25 transcervical (31B2) and 10 basicervical (31B3) fractures were detected. The mean alpha angle on lateral X-ray of the operated side was statistically significantly higher than the unaffected side. The mean alpha angle on CT was higher on the operated side than the unaffected side. In addition, the acetabular version angle on CT was higher on the unaffected side while acetabular depth on CT was higher on the operated side. The lateral CE angle on the AP X-ray was not different on the unaffected side compared to the operated side. Conclusion: Symptoms of impingement can be seen in patients undergoing internal fixation after femoral neck fracture, and a decrease in acetabular version and an increase in acetabular depth may be predisposing to femoral neck fracture.

scholarly journals Decreased Complications but a Distinctive Fixation Loosening Mechanism of Fully Threaded Headless Cannulated Screw Fixation for Femoral Neck Fractures in Young Adults.

2021 ◽  
Author(s):  
Hui Sun ◽  
Lin-Yuan Shu ◽  
Sherrier Matthew ◽  
Yi Zhu ◽  
Jing-Wen Liu ◽  
...  
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Young Patients ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Low Energy ◽  
Cannulated Screws ◽  
Fixation Failure ◽  
Fracture Patterns

Abstract Background: Despite being a commonly encountered injury in orthopaedic practice, controversy surrounds the methods of optimal internal fixation for femoral neck fractures (FNF) in young patients. The objective of the present study is to compare complication rates and failure mechanisms for surgical fixation of FNF using fully threaded headless cannulated screws (FTHCS) versus partial threaded cannulated screws (PTS) in young adults.Methods: A total of 75 patients (18-65 years old) with FNF were prospectively treated with close reduction and internal fixation using three parallel FTHCS and compared to a historical control case-matched group (75 patients) with FNF treated by PTS fixation. After two years follow-up, rates of fixation failure (including varus collapse, fracture displacement, and femoral neck shortening), nonunion, and avascular necrosis of the femoral head (ANFH) were compared between the two cohorts. The demographic, follow-up information, and radiological images were assessed by independent blinded investigators. Results: Patient demographics and fracture patterns were similar in the two patient groups. The overall fixation failure rates were 8% (6/75) in the FTHCS cohort, which was significantly lower than the 25.3% (19/75) seen in the PTS group. Rates of nonunion and ANFH were significantly lower in the FTHCS group when compared to the PTS control group. When stratified by injury severity (high-energy versus low-energy fractures), the rate of fixation failure was significant lower with the use of FTHCS when compared with PTS for high-energy fractures while there was no difference in the rates of nonunion or ANFH for high or low-energy fracture patterns. Unique to the FTHCS cohort was an atypical screw migration pattern with varus collapse (6/75, 8%). Conclusions: The results show that FTHCS fixation could significantly reduce the complication rate of young patients with FNF, especially in high-energy fracture patterns (Garden III-IV, Pauwels III or vertical of the neck axis (VN) angle ≥ 15°). There was also confirmation that the modes of fixation loosening in the FTCHS group, including screw “medial migration” and superior cutout, were different from the screw withdrawal pattern seen in the PTS cohort. Trial registration: The study was retrospectively registered at www.Chictr.org.cn (ChiCTR-IPR-1900025851) on September 11, 2019.

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