scholarly journals Dyslipidaemia for patients with low-energy femoral neck fractures after the treatment of cancellous screws: a retrospective study with a 3-year minimum follow-up

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Chi Zhang ◽  
Xiaoxiao Zhu ◽  
Genwang Pei ◽  
Ping Xu ◽  
Xianshang Zeng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Low Energy ◽  
Cancellous Screws

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 Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yunfeng Tang ◽  
Zhen Zhang ◽  
Limin Wang ◽  
Wei Xiong ◽  
Qian Fang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Blood Loss ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Femoral Neck Fractures ◽  
Intraoperative Blood Loss ◽  
Incision Length ◽  
Cancellous Screws

Abstract Background The femoral neck system (FNS) may be a valid alternative for treating femoral neck fractures, but few studies have compared the outcomes between FNS and cannulated cancellous screws. This study aimed to compare the clinical efficacy and complications of FNS with those of inverted cannulated cancellous screws (ICCS) for the treatment of femoral neck fractures in adults. Methods This retrospective study evaluated patients with femoral neck fractures who underwent FNS or ICCS internal fixation between June 2019 and January 2020. The operative time, intraoperative blood loss, number of fluoroscopies, length of surgical incision, length of hospital stay, time to fracture healing, and other indicators were compared between the two groups. The incidence of complications such as nonunion, avascular necrosis of the femoral head, loosening of the internal fixation, and shortening of the femoral neck during follow-up was also assessed in both groups. Results Among the 92 patients included, 47 and 45 patients were categorized into the FNS and ICCS groups, respectively. Follow-up ranged from 14 to 24 months. There were no significant between-group differences in sex, age, side of the injured limb, and type of fracture and in operative time, intraoperative blood loss, incision length, and length of hospital stay (all P > 0.05). The incidence of complications such as fracture nonunion, avascular necrosis of the femoral head, and screw loosening was also comparable between the two groups. However, the number of fluoroscopies was significantly lower in the FNS group than in the ICCS group (P < 0.05). The fracture healing time was also significantly lower in the FNS group than in the ICCS group (P < 0.05). Furthermore, the femoral neck shortening and Harris hip score at the last follow-up were significantly better in the FNS group than in the ICCS group (P < 0.05). Conclusions FNS for femoral neck fractures improves hip functional recovery and reduces the femoral neck shortening rate and fluoroscopy exposure postoperatively. Thus, FNS can be an alternative to ICCS for the treatment of femoral neck fractures.

scholarly journals Cannulated cancellous screws versus dynamic hip screw in femoral neck fractures: a comparison in productive age group at tertiary care hospital of North India

2020 ◽  
Vol 7 (1) ◽  
pp. 44
Author(s):  
Sakib Arfee ◽  
Akib Arfee ◽  
Adnan Aadil Arfee
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Dynamic Hip Screw ◽  
Harris Hip Score ◽  
Age Group ◽  
Fracture Neck Femur ◽  
Hip Screw ◽  
Cancellous Screws ◽  
Lost To Follow Up

<p class="abstract"><strong>Background:</strong> Since intracapsular fracture neck femur was recognized by Ambrose Pare almost 4 centuries back, the management of intracapsular neck femur fracture has undergone many changes. The multitude of various implants designed and techniques available for its treatment themselves indicate the inadequacy of the various methods of treatment.  Objective was to compare cannulated cancellous screws (CCS) versus dynamic hip screw (DHS) in femoral neck fractures in productive age group.</p><p class="abstract"><strong>Methods:</strong> This observational study with both prospective and retrospective data analysis of patients operated by different surgeons in same hospital setup has been conducted from March, 2018 to February, 2020 at the department of Orthopedics, Government Medical College (GMC), Jammu. 105 cases satisfying the inclusion criteria admitted in GMC Jammu were included clinically and radiologically. Total number of patients included in the study was 97 patients as 8 patients were lost to follow-up. Functional outcome was evaluated by using Harris hip scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study 8 CCS cases were lost to follow up. Total 97 of cases were followed up till one year both radiologically and clinically after a given time intervals and final assessment done on the basis of Harris hip score. Among 97 cases 71 were males most of them in age group of 41-45 years and 26 were females with 46-50 years age group predominance. 47.42% fractures were classified as type III in garden’s staging.  </p><p class="abstract"><strong>Conclusions:</strong> DHS is a better implant than CCS in hands of doctors who lack of expertise and precision i.e. required for CCS in fracture neck femur in young adult patients.</p>

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.

scholarly journals Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Clinical Outcomes ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Total Hip ◽  
Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

scholarly journals The follow-up study of the prosthetic-replacement for the femoral neck fractures.

1984 ◽  
Vol 32 (3) ◽  
pp. 625-629
Author(s):  
K. Sai ◽  
I. Tomonaga ◽  
S. Kanemitsu ◽  
K. Kitano ◽  
K. Adachi ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Prosthetic Replacement ◽  
Follow Up Study

Subspecialty Fellowship Training is Not Associated with Better Outcomes in Fixation of Low Energy Femoral Neck Fractures – An Analysis of the FAITH Database

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ryan D. DeAngelis ◽  
Matthew K. Stein ◽  
Gregory T. Minutillo ◽  
Nikhilesh G. Mehta ◽  
Emil H. Schemitsch ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Fellowship Training ◽  
Femoral Neck Fractures ◽  
Low Energy

scholarly journals Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽  
2013 ◽  
Vol 49 (3) ◽  
pp. 22
Author(s):  
Jaunius Kurtinaitis ◽  
Narūnas Porvaneckas ◽  
Giedrius Kvederas ◽  
Tomas Butėnas ◽  
Valentinas Uvarovas
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Neck Fractures ◽  
Total Hip ◽  
Significant Difference ◽  
Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

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