scholarly journals Imaging observation of percutaneous compression plate use in promoting femoral neck fracture healing

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110335
Author(s):  
Yong Chen ◽  
Haifeng Li ◽  
Liansheng Dai ◽  
Qudong Yin ◽  
Dong Li ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Harris Hip Score ◽  
Secondary Outcome ◽  
Compression Plate ◽  
Neck Fracture ◽  
Percutaneous Compression Plate

Objective To examine the imaging evidence of the use of percutaneous compression plate (PCCP) in promoting femoral neck fracture healing compared with cannulated screws (CS). Methods This retrospective study enrolled patients with femoral neck fractures undergoing internal fixation procedures. The patients were divided into a PCCP group and a CS group with imaging as the primary outcome and Harris hip score (HHS) as the secondary outcome. Results This study included 162 patients: 80 in the PCCP group and 82  in the CS group. There were no significant differences between the patients in their preoperative baseline characteristics. Patient follow-up ranged from 24–56 months (mean 30.7 months). Differences in reduction quality, screw slipping, neck shortening and avascular necrosis (AVN) were not significant between the two groups. There were significant differences between the treatment groups in bone absorption, nonunion, healing time, screw withdrawal and fixation failure in favour of the PCCP group. Postoperative HHS at 6 and 12 months were significantly better for the PCCP group than the CS group, but the differences were not significant at 24 months and last follow-up. Conclusion Stable internal fixation with dynamic compression was the key to PCCP promoting femoral neck fracture healing.

scholarly journals Results of the application of a new method of internal fixation of femoral neck fractures - self-tapping antirotation cannulated screws (SAF)

2013 ◽  
Vol 60 (2) ◽  
pp. 71-79
Author(s):  
Igor Kostic ◽  
Milan Mitkovic ◽  
Milorad Mitkovic
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Functional Recovery ◽  
Femoral Neck Fractures ◽  
New Method ◽  
Cannulated Screws ◽  
Neck Fracture

Introduction: Femoral neck fractures are one of the most common fractures primarily the elderly, coupled with a high degree of morbidity and mortality. The treatment is applied a number of methods of internal fixation (multiple cannulated screws available, DHS system, cefalomedullary). At the Department of Orthopedics and Traumatology of Nis developed a new method of fixation of femoral neck fracture, which allows stable fixation of dislocated and nondislocated femoral neck fracture. Self-tapping antirotation fixation (SAF) using two cannulated screws to initial compression fractures intraoperative and postoperative dynamic linear compression of the fracture with early full support to the patient. Matherial and methods: In the period between 2008 to 2012, 53 patients treated for femoral neck fracture in the Clinic for orthopedic and traumatology, Clinical center in Nis, Serbia, by SAF (the self-tapping cannulated screws antirotation; ORTOKON doo Nis). All patients were followed up after surgery in a minimum period of 13 weeks (13-106 weeks). The outcome was evaluated on the basis of clinical and radiological signs of fracture healing and the Harris hip score of functional recovery of the patient. Results: Of the total number of patients (53) treated with this method of fixation, 31 of them were females and 22 males, mean age 52.7 years (28-75 years). The average time of surgery was 36.4 minutes (19-70 minutes). During the postoperative follow-up of all patients (53) operated by this method, six patients were lost in the further postoperative monitoring, so that 47 patients remained for final evaluation. The total incidence of nonunion of femoral neck fracture after surgery this method was 6.4% (three patients). Shortening of the femoral neck after fixation by this method was recorded in 27 cases, and what amounted to an average of 2.8 mm (1, 2 mm in nondislocated to 4.55 with dislocated fracture) and did not affect the functional outcome. During radiographic follow-up was not detected fracture implants. Conclusion: Self-tapping screws cannulated antirotacioni (SAF method) represent a reliable method of fixation of dislocated and nondislocated femoral neck fracture. The main prerequisite for the proper healing of femoral neck fractures with this method is that anatomical fracture reduction is achieved by a closed or open method. This way of fixation allows the early full weight bearing patient operated limb and faster postoperative functional recovery of the fracture healing in optimal time.

scholarly journals Comparison of the clinical efficacy of a femoral neck system versus cannulated screws in the treatment of femoral neck fracture in young adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Changjun He ◽  
Yao Lu ◽  
Qian Wang ◽  
Cheng Ren ◽  
Ming Li ◽  
...  
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Healing Time ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Neck Fracture ◽  
Hip Function

Abstract Background To compare the clinical efficacy of a femoral neck system (FNS) and cannulated screws (CS) in the treatment of femoral neck fracture in young adults. Methods Data from 69 young adults, who were admitted for femoral neck fracture between March 2018 and June 2020, were retrospectively analyzed. Patients were divided into two groups according to surgical method: FNS and CS. The number of intraoperative fluoroscopies, operative duration, length of hospital stay, fracture healing time, Harris score of hip function, excellent and good rate of hip function, and postoperative complications (infection, cut out the internal fixation, nail withdrawal, and femoral neck shortening) were compared between the two groups. Hip joint function was evaluated using the Harris Hip Scoring system. Results All 69 patients had satisfactory reduction and were followed up for 12–24 months, with a mean follow-up of 16.91 ± 3.01 months. Mean time to fracture healing was13.82 ± 1.59 and 14.03 ± 1.78 weeks in the FNS and CS groups, respectively. There was a statistical difference in the number of intraoperative fluoroscopies between the 2 groups (P = 0.000). There were no significant differences, in operation duration, hospital length of stay, fracture healing time, complications, Harris Hip Score for hip function and excellent and good rate between the two groups (P > 0.05). The incidence of complications was 6.1%(2/33) in the FNS group lower than 25%(9/36) in the CS group, a difference that was statistically significant (P = 0.032). At the last follow-up, the Harris Hip Score of the hip joint in the FNS group was 90.42 ± 4.82and 88.44 ± 5.91 in the CS group. Conclusions Both treatment methods resulted in higher rates of fracture healing and excellent hip function. Compared with CS, the FNS reduced the number of intraoperative fluoroscopies, radiation exposure to medical staff and patients, and short-term complications including femoral neck shortening and bone nonunion.

scholarly journals Long-term follow-up outcomes for patients undergoing primary total hip arthroplasty with uncemented versus cemented femoral components: a retrospective observational study with a 5-year minimum follow-up

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Tiejian Liu ◽  
Xiaoxiao Hua ◽  
Weiguang Yu ◽  
Jinluan Lin ◽  
Mingdong Zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Secondary Outcome ◽  
Total Hip ◽  
Neck Fracture

Abstract Background This retrospective analysis compared the long-term outcomes for patients with a femoral neck fracture (AO/OTA type 31B) treated with a primary unilateral total hip arthroplasty with uncemented or cemented femoral components (UTHA or CTHA, respectively). Methods We conducted a retrospective cohort study using the South China Hip Arthroplasty Database. We identified 422 patients with femoral neck fracture (AO/OTA type 31B) who were previously treated with primary unilateral UTHA or CTHA between 2007 and 2015, with follow-up until 2019. Follow-up occurred 1, 3, 6 and 12 months postoperatively and yearly thereafter. The primary outcome was the Harris hip score (HHS). The secondary outcome was the orthopaedic complication rate. Results In total, 324 patients (UTHA n = 160, mean age 68.61 ± 7.49 years; CTHA n = 164, mean age 68.75 ± 7.04 years) were evaluated for study eligibility. The median follow-up was 73.3 months (range, 11.6–89.2 months). At the final follow-up, HHS was 74.09 ± 6.23 vs 79.01 ± 10.21 (UTHA vs CTHA, p = 0.012). Significant differences were detected in the incidence of prosthetic revision, loosening, and periprosthetic fracture between the UTHA and CTHA groups (7.5% for UTHA vs 1.8% for CTHA, p = 0.015; 17.5% for UTHA vs 8.5% for CTHA, p = 0.016; 11.9% for UTHA vs 4.9% for CTHA, p = 0.021, respectively). Conclusion In this setting, CTHA demonstrated superiority to UTHA by improving functional outcomes and decreasing complication rates.

scholarly journals Pauwels screw combined inverted triangle cannulated screws for the treatment of Pauwels type-III femoral neck fracture:- a new surgical method based on the morphology of the fracture

2020 ◽  
Author(s):  
Gang Xue ◽  
Siting Chen ◽  
Maosheng Zhou ◽  
Zhengyu Wang ◽  
Liangliang Wan ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Type Iii ◽  
Operative Duration ◽  
Neck Fracture ◽  
Flexion And Extension

Abstract Background: Femoral neck fracture is a serious injury in adults with significant functional consequences.Internal fixtion is an established treatment for femoral neck fractures in young adult patients .However, the risk of complications following fixation has plague orthopedists for decades.In all femoral neck fracture ,Pauwels type-III femoral neck fractures with a large vertical shear force were more likely to cause clinical failure.The aim of this study is to intruduce a new surgical technique for the treatment of this fracture according to the morphology of the fracture using the combination of Pauwels screw and inverted triangle cannulated screws(PSTCS)，and report the clinical effects in a prospective cohort of 14 patients.Methods: From June 2017 to June 2019, a total of 14 patients (8 males and 6 females ) with Pauwels type-III femoral neck fracture underwent the surgical treatment of PSTCS according to the morphologyical types of fracture in clinical operation in our department. Patients were allowed to perform contraction exercises of quadriceps femoris on postoperative day1, passive flexion and extension exercises postoperative day 2 onwards, and active flexion and extension exercises postoperative day 7 onwards. Patients were allowed for partial-weight bearing walking postoperative 1month onwards with axillary crutches. After one month AP and lateral radiograph were taken. Full ambulation was permitted until the presence of radiological consolidation.Intraoperative (Operative duration,Blood loss),postoperation(Fracture union time,The Harris Hip Score,Visual analog score) were record for comparison.Results: All patients were followed up for at least 12 months.In the end point of the follow up ,12 of the 14 patients (85.7%)with pauwels type-III femoral neck fractures had achieved satisfactory hip function. Operative duration was a mean of 49.5 ±10.4 minutes.Intraoperative blood loss was between 26 and 110 ml (mean, 44.4±20.6ml) and without intraoperative blood transfusion . The Harris Hip Score was between 64 and 95(mean,87.6±8.9).Fracture healing was observed in all patients according to the X-ray . No internal fixation was loosened or screw cut-out in the follow-up period.The femoral head necrosis was observed in 1 patient in this study. In addition, there was no obvious fracture displacement, femoral neck shortening, or hip varus. Conclusions: The study showed that PSTCS can provide a satisfactory clinical outcomes for treatment of pauwels type-III femoral neck fractures.Most patients (85.7%) achieved good or excellent results with the use of PSTCS,which appears to be a reliable method and provides another choice for this problematic fracture.The new internal fixation method of PSTCS can provide mechanical stability and promote fracture healing

Factors influencing femoral neck fracture healing after internal fixation with dynamic locking plate

2019 ◽  
Vol 139 (5) ◽  
pp. 629-638 ◽  
Author(s):  
Radoslav Morochovič ◽  
Katarína Takáčová ◽  
Ľuboš Tomčovčík ◽  
Peter Cibur ◽  
Rastislav Burda
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Locking Plate ◽  
Factors Influencing ◽  
Neck Fracture

scholarly journals Computer-assisted cannulated screw internal fixation versus conventional cannulated screw internal fixation for femoral neck fractures: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qing-hao Cheng ◽  
Peng-biao Li ◽  
Ting-ting Lu ◽  
Shi-fang Guo ◽  
Wen-fei Di ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Meta Analysis ◽  
Operation Time ◽  
Healing Time ◽  
Cannulated Screw ◽  
Computer Assisted ◽  
Neck Fracture

Abstract Objective To compare the effects between computer-assisted and traditional cannulated screw internal fixation on treating femoral neck fracture. Methods The search was conducted in Embase, Pubmed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database from the beginning to August 2020. RevMan5.4 software, which was provided by the International Cochrane Group, was used for the meta-analysis comparing the differences in operation time, intraoperative bleeding volume, fluoroscopy frequency, fracture healing time, total drilling times, Harris score, fracture healing rate, and femoral head necrosis rate between computer-assisted and traditional methods groups. Results A total of 1028 patients were included in 16 studies. Primary outcome indicators: Compared with the traditional method group, the computer-assisted group had less operative time (2RCTs, P < 0.00001; 8 non-RCTs, P = 0.009; Overall, P < 0.00001), intraoperative bleeding (1 RCTs, P < 0.00001; 9non-RCTs, P < 0.00001; Overall, P < 0.00001), femoral head necrosis rate (1 RCT, P = 0.11;7 non-RCTs, P = 0.09; Overall, P = 0.02) and higher Harris scores (1 RCT, P < 0.0001; 9 non-RCTs, P = 0.0002; Overall, P < 0.0001), and there were no significant differences in fracture healing rate between the two groups (5 non-RCTs, P = 0.17). Secondary outcomes indicators: The computer-assisted group had a lower frequency of intraoperative fluoroscopy and total number of drills compared with the traditional method group, while there was no significant difference in fracture healing time. Conclusion Compared with the traditional hollow screw internal fixation on the treatment of femoral neck fracture, computer-assisted percutaneous cannulated screw fixation can shorten the operation time and improve the operation efficiency and reduce the X-ray injury of medical staff and help patients obtain a better prognosis. Therefore, computer-assisted percutaneous cannulated screw fixation is a better choice for the treatment of femoral neck fracture. Study registration PROSPERO registration number CRD42020214493.

scholarly journals Treatment of Femoral Neck Fracture with Percutaneous Compression Plate: Preliminary Results in 74 Patients

2015 ◽  
Vol 7 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Feng Zhu ◽  
Gang Liu ◽  
Hong-guo Shao ◽  
Yi-jun Wang ◽  
Rong-qun Li ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Preliminary Results ◽  
Compression Plate ◽  
Neck Fracture ◽  
Percutaneous Compression Plate

scholarly journals Application of Robot Positioning for Cannulated Screw Internal Fixation in the Treatment of Femoral Neck Fracture: Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Lei Wan ◽  
Xiangyun Zhang ◽  
Dalong Wu ◽  
Zhihao Li ◽  
Dongtao Yuan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Cannulated Screw ◽  
Control Group ◽  
Study Group ◽  
Robot Assisted ◽  
Neck Fracture

BACKGROUND Femoral neck fracture is a common type of hip fracture. Conventional surgical treatment aims at fixing the fracture site with screws and then gradually promoting bone healing. A robot-assisted orthopedic surgery system is computer technology applied to surgical treatment. OBJECTIVE This study aimed to explore the therapeutic effect and prognostic value of percutaneous cannulated screw internal fixation using robot-assisted positioning in patients with femoral neck fractures. METHODS From July 2018 to September 2019, 42 cases of femoral neck fracture admitted to the Second Affiliated Hospital of Luohe Medical College were randomly and averagely divided into control and study groups. The patients in the control group were treated with conventional percutaneous cannulated screw internal fixation, while the patients in the study group were treated with robot-assisted percutaneous cannulated screw fixation during surgical treatment. We compared the treatment conditions and results of the operation between the 2 groups. The Harris score was used to evaluate the treatment efficacy. The state of fracture healing was followed up and compared between the 2 groups. RESULTS The duration of the operation was shorter, there was less fluoroscopy use, and there were fewer drilled holes in the study group than in the control group (all, <i>P</i>&lt;.001). There was no statistical difference in the amount of intraoperative bleeding between the 2 groups (<i>P</i>=.33). The Harris score (<i>P</i>=.045) and number of excellent and good ratings (<i>P</i>=.01) were significantly higher in the study group than in the control group. The difference in the fracture healing rate between the 2 groups was not statistically significant (<i>P</i>=.23). The fracture healing duration of the study group was shorter than that of the control group (<i>P</i>=.001). CONCLUSIONS The use of robotic positioning aids in the treatment of femoral neck fractures with percutaneous cannulated screw fixation can effectively improve the efficiency of surgery, shorten the duration of surgery, and reduce the radiation damage to patients. Meanwhile, it improves postoperative treatment and recovery rates of the patients and shortens the fracture healing time.

scholarly journals Application of Robot Positioning for Cannulated Screw Internal Fixation in the Treatment of Femoral Neck Fracture: Retrospective Study

10.2196/24164 ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. e24164
Author(s):  
Lei Wan ◽  
Xiangyun Zhang ◽  
Dalong Wu ◽  
Zhihao Li ◽  
Dongtao Yuan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Cannulated Screw ◽  
Control Group ◽  
Study Group ◽  
Robot Assisted ◽  
Neck Fracture

Background Femoral neck fracture is a common type of hip fracture. Conventional surgical treatment aims at fixing the fracture site with screws and then gradually promoting bone healing. A robot-assisted orthopedic surgery system is computer technology applied to surgical treatment. Objective This study aimed to explore the therapeutic effect and prognostic value of percutaneous cannulated screw internal fixation using robot-assisted positioning in patients with femoral neck fractures. Methods From July 2018 to September 2019, 42 cases of femoral neck fracture admitted to the Second Affiliated Hospital of Luohe Medical College were randomly and averagely divided into control and study groups. The patients in the control group were treated with conventional percutaneous cannulated screw internal fixation, while the patients in the study group were treated with robot-assisted percutaneous cannulated screw fixation during surgical treatment. We compared the treatment conditions and results of the operation between the 2 groups. The Harris score was used to evaluate the treatment efficacy. The state of fracture healing was followed up and compared between the 2 groups. Results The duration of the operation was shorter, there was less fluoroscopy use, and there were fewer drilled holes in the study group than in the control group (all, P<.001). There was no statistical difference in the amount of intraoperative bleeding between the 2 groups (P=.33). The Harris score (P=.045) and number of excellent and good ratings (P=.01) were significantly higher in the study group than in the control group. The difference in the fracture healing rate between the 2 groups was not statistically significant (P=.23). The fracture healing duration of the study group was shorter than that of the control group (P=.001). Conclusions The use of robotic positioning aids in the treatment of femoral neck fractures with percutaneous cannulated screw fixation can effectively improve the efficiency of surgery, shorten the duration of surgery, and reduce the radiation damage to patients. Meanwhile, it improves postoperative treatment and recovery rates of the patients and shortens the fracture healing time.

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