Valgus Osteotomy of the Proximal Femur with Sliding Hip Screw for the Treatment of Femoral Neck Nonunions: The Technique, a Case Series, and Literature Review

2006 ◽  
Vol 20 (7) ◽  
pp. 485-491 ◽  
Author(s):  
Andrew J. Schoenfeld ◽  
Gregory A. Vrabec
Keyword(s):  
Literature Review ◽  
Femoral Neck ◽  
Proximal Femur ◽  
Case Series ◽  
Valgus Osteotomy ◽  
Sliding Hip Screw ◽  
Hip Screw

scholarly journals Principles of Valgus Intertrochanteric Osteotomy (VITO) after Femoral Neck Nonunion

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
D. Banaszek ◽  
D. Spence ◽  
P. O’Brien ◽  
K. Lefaivre
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Proximal Femur ◽  
Treatment Options ◽  
Intertrochanteric Osteotomy ◽  
Valgus Osteotomy ◽  
Challenging Problem ◽  
The Individual ◽  
Technical Considerations

Nonunion is a relatively rare, yet challenging problem after fracture of the femoral neck. Risk factors include verticality of the fracture line and presence of comminution of the posteromedial calcar, as well as quality of reduction. Treatment options consist of valgus intertrochanteric osteotomy versus arthroplasty. Treatment should be tailored to the individual patient, taking into account patient age and activity demands. This review outlines the principles and technical considerations for valgus osteotomy of the proximal femur in the setting of femoral neck nonunion.

A new technique for cement augmentation of the sliding hip screw in proximal femur fractures

2008 ◽  
Vol 23 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Karl K. Stoffel ◽  
Toby Leys ◽  
Nikki Damen ◽  
Rochelle L. Nicholls ◽  
Markus S. Kuster
Keyword(s):  
Proximal Femur ◽  
Cement Augmentation ◽  
New Technique ◽  
Sliding Hip Screw ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Hip Screw ◽  
A New Technique

scholarly journals Sliding hip screw versus cannulated cancellous screws for fixation of femoral neck fracture in adults: A systematic review

2018 ◽  
Vol 52 ◽  
pp. 89-97 ◽  
Author(s):  
Jian-xiong Ma ◽  
Ming-jie Kuang ◽  
Fei Xing ◽  
Yun-long Zhao ◽  
Heng-ting Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Sliding Hip Screw ◽  
Neck Fracture ◽  
Hip Screw ◽  
Cancellous Screws

A model to evaluate Pauwels type III femoral neck fractures

2018 ◽  
Vol 232 (3) ◽  
pp. 310-317 ◽  
Author(s):  
Kevin M Magone ◽  
Jonas K Owen ◽  
Bernard P Kemker ◽  
Oliver Bloom ◽  
Sidney Martin ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Fracture Repair ◽  
Fourth Generation ◽  
Unstable Fracture ◽  
Cannulated Screws ◽  
Sliding Hip Screw ◽  
Neck Shaft Angle ◽  
Inverted Triangle ◽  
Hip Screw

While many femoral neck fractures can be reliably treated with surgical intervention, Pauwels III femoral neck fractures in the young adult population continue to be a challenging injury, and there is no consensus on optimal treatment. As such, there are past and ongoing biomechanical studies to evaluate the fixation provided by different constructs for this inherently unstable fracture. While many investigations rely on cadavers to evaluate the biomechanical performance of a construct, significant inter-subject variability can confound the analysis. Biomechanical femur analogs are being used more frequently due to more consistent mechanical properties; however, they have not been stringently evaluated for morphology or suitability for instrumentation. This study sought to determine the variability among composite femoral analogs as well as consistently create a Pauwels III injury and instrument the analogs without the need for fluoroscopic guidance. In total, 24 fourth-generation composite femoral analogs were evaluated for femoral height, neck–shaft angle, anteversion, and cortical thickness. A method was developed to simulate a Pauwels III fracture and to prepare three different constructs: an inverted triangle of cannulated screws, a sliding hip screw, and a hybrid inverted triangle with cannulated screws and a sliding hip screw. Radiographs were utilized to evaluate the variation in implant position. All but one of the morphological parameters varied by <1%. The tip-to-apex distance for all sliding hip screw hardware was 18.8 ± 3.3 mm, and all relevant cannulated screw distances were within 5 mm of the adjacent cortex. All screws were parallel, on average, within 1.5° on anterior–posterior and lateral films. Fourth-generation composite femora were found to be morphologically consistent, and it is possible to consistently instrument the analogs without the use of fluoroscopy. This analog and hardware implantation model could serve as a screening model for new fracture repair constructs without the need for cadaveric tissues or radiologic technology.

scholarly journals A Case of Two Consecutive Peri-Implant Fractures After Treatment of an Incomplete Stress Fracture of the Femoral Neck with a Sliding Hip Screw Device in a Young Adult

2019 ◽  
pp. 1-4
Author(s):  
Utkarsh Anil ◽  
Abhishek Ganta ◽  
Sanjit R Konda
Keyword(s):  
Young Adult ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Trochanteric Fracture ◽  
Atypical Presentation ◽  
Sliding Hip Screw ◽  
Postoperative Course ◽  
Neck Fracture ◽  
Surgical Fixation ◽  
Hip Screw

We present an atypical presentation of a non-displaced femoral neck fracture in a young adult after a fall from standing sustained 4 days prior to presentation. Patient underwent surgical fixation with a sliding hip screw, the postoperative course of which was complicated by an atraumatic peri-implant greater trochanteric fracture, requiring surgery for open reduction and internal fixation. The course was further complicated by another atraumatic peri-implant femoral neck fracture after which, the patient was definitely treated with a total hip arthroplasty.

scholarly journals Complications of femoral neck fracture fixation using a sliding hip screw with a side plate device in patients older than 65 years

2020 ◽  
Author(s):  
Tatsuya Mitsugi ◽  
Hideaki Miyamoto ◽  
Masahiro Izumi ◽  
Kentaro Matsui ◽  
Keisuke Ishii ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Fracture Fixation ◽  
Periprosthetic Fracture ◽  
Sliding Hip Screw ◽  
Aseptic Necrosis ◽  
Side Plate ◽  
Loss Of Reduction ◽  
Neck Fracture ◽  
Hip Screw ◽  
One Year

Abstract BackgroundA majority of femoral neck fractures are indicated for surgical treatment within the scope of applicable guidelines. However, the reported overall complication rate in elderly patients one year after hip fracture fixation was 33.3%. The purpose of this study was to clarify the incidence of complications one year after femoral neck fracture fixation using a sliding hip screw with a side plate device in elder than 65-year-old patients.MethodsWe studied the results of 115 cases of the internal fixation for femoral neck fractures in patients older than 65 years of age using the Twins device (HOYA Technosurgical Corporation, Tokyo, Japan). We could follow up 39 of these 115 cases at one year after fixation and retrospectively investigated complications in these patients. Research outcomes were mortality, surgical site infection (SSI), loss of reduction, aseptic necrosis, late segmental collapse (LSC), nonunion, periprosthetic fracture, reoperation, and recovery of walking ability.ResultsThe patients consisted of 13 men and 26 women (mean age 80.5 years, range 65-104 years). Mortality was observed in four cases (14.2%), SSI in one case (2.5%), loss of reduction in six cases (15.4%), aseptic necrosis in seven cases (17.9%), LSC in three cases (7.6%), nonunion in eight cases (20.5%), periprosthetic fracture in three cases (7.6%), and reoperation was performed in seven cases (17.9%), respectively. In 28 cases, the patients could walk independently before injury; this decreased to 19 cases after injury (67.9%).ConclusionsIn our study, the incidence of loss of reduction rate and periprosthetic fracture rate were relatively high. Other complications of the Twins device evaluated were equivalent to those reported previously.

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