scholarly journals Multiple Cannulated Screw Fixation of Femoral Neck Fractures with Comminution in Young and Middle Age Patients

2021 ◽  
Author(s):  
Zhe Han ◽  
Taxi Wumiti ◽  
Nengneng Ji ◽  
Xiang Sun ◽  
Chao Han ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Femoral Neck ◽  
Screw Fixation ◽  
Life Quality ◽  
Cannulated Screw ◽  
Occurrence Rate ◽  
Harris Hip Score ◽  
Fixation Failure ◽  
Aged Patients

Abstract Objective To investigate the distribution and influence of comminutions on femoral neck fracture (FNF) patients after cannulated screw fixation (CSF). Methods From January 2019 to June 2020, a total of 473 patients with FNF treated by CSF, aged 23–65 years, were included in present study. Based on location of the cortical comminution, the FNF patients were assigned as comminution group (anterior comminution, posterior comminution, superior comminution, inferior comminution, multiple comminutions) and without comminution group. The incidence of postoperative complications, quality of life and functional outcomes were recorded in different groups at 1 year-follow up. Results The comminution was more likely to appear in displaced FNF patients (86.8%) compared with non-displaced FNF patients (8.9%), while occurrence rate of comminution was also closely associated with Pauwels classification (3.2% vs 53.5% vs 83.9%, P<0.05). Besides, the incidence of osteonecrosis of femoral head (ONFH, 11.3% vs 2.9%, P<0.05), nonunion (7.5% vs 1.7%, P<0.05), femoral neck shortening (21.6% vs 13.4%, P<0.05) and internal fixation failure (11.8% vs 2.9%, P<0.05) in FNF patients with comminutions, especially with multiple comminutions, was significantly higher than those in FNF patients without comminution. Furthermore, there was a prominently difference in Harris hip score (HHS, 85.6±15.6 vs 91.3±10.8, P<0.05) and EuroQol five dimensions questionnaire (EQ-5D, 0.85±0.17 vs 0.91±0.18, P<0.05) score between FNF patients with comminution and FNF patients without comminution, whereas there was seem to be no significantly difference in Visual analogue scale (VAS, 1.46±2.49 vs 1.13±1.80, P>0.05) score between two groups at 1 year after surgery. Conclusion In our view, the comminution, easily happened in displaced FNF and Pauwel type III FNF, which was deemed to be a risk factor for postoperative complications in young and middle-aged patients underwent CSF, consequently causing an influence on recovery of hip function and life quality. However, further evaluation with better study design, larger sample and long-term follow-up was still imminently applied.

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

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.

Cannulated Screw Fixation of Femoral Neck Fractures in Elderly Patients

Swiss Surgery ◽  
2001 ◽  
Vol 7 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Sträuli ◽  
Seekamp ◽  
Lehmann ◽  
Bosch
Keyword(s):  
Femoral Neck ◽  
Elderly Patients ◽  
Screw Fixation ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Wird Eine ◽  
Eine Analyse

112 mediale Schenkelhalsfrakturen wurden unabhängig vom Dislokationsgrad bei 110 Patienten mit einem Durchschnittsalter von 78.4 Jahren (25-96 Jahre) zwischen 1.6.97 und 31.12.98 im Rahmen einer prospektiven Beobachtungsstudie kopferhaltend mit einer Schraubenosteosynthese versorgt. Mit einem durchschnittlichen Follow-up von 6.8 Monaten (3-16 Monate) konnten 60 Patienten mit 61 Frakturen klinisch und radiologisch nachkontrolliert werden. 22.7% der Patienten sind während der Beobachtungszeit verstorben. 68.9% der nachkontrollierten Frakturen sind geheilt. Eine Partial- oder Totalnekrose des Hüftkopfes ist in 18%, eine Pseudarthrose in 8.2% und eine Dislokation in 4.9% der Fälle aufgetreten. 18 Patienten (29.5%) mussten reoperiert werden, wobei 1/3 auf Schraubenwechsel oder Schraubenentfernungen, 2/3 auf eine sekundäre Alloarthroplastik entfallen. Bezüglich Schmerzen konnte in 81.6% (unter Ausschluss der mit einer Prothese reoperierten Patienten) ein gutes Resultat erreicht werden. In der Diskussion wird eine Analyse der möglichen Fehlerquellen vorgenommen mit dem Ziel, künftig mit der Schraubenosteosynthese eine noch bessere Heilungsrate zu erzielen.

scholarly journals TiRobot ‐Assisted Percutaneous Cannulated Screw Fixation in the Treatment of Femoral Neck Fractures: A Minimum 2‐Year Follow‐up of 50 Patients

2021 ◽  
Vol 13 (1) ◽  
pp. 244-252
Author(s):  
Zong‐dong Zhu ◽  
Cheng‐wei Xiao ◽  
Bo Tan ◽  
Xiao‐ming Tang ◽  
Dan Wei ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Screw Fixation ◽  
Femoral Neck Fractures ◽  
Cannulated Screw

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 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 Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

2021 ◽  
Vol 15 (5) ◽  
pp. 988-991
Author(s):  
Zamir Hussain Tunioi ◽  
Rizwan Ali Jhatiyal ◽  
M Azeem Akhund ◽  
M Kashif Abbasi ◽  
L Das Maheshwari ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Cross Sectional ◽  
Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

Comparison of the Effects of Two Different Hollow Nails in the Treatment of the Young Pauwels Type Ⅲ Femoral Neck Fractures

2021 ◽  
Author(s):  
WENJING CHENG ◽  
GUOZHENG - DING
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Avascular Osteonecrosis ◽  
Significant Difference ◽  
Group A ◽  
Random Number Table ◽  
Screw Withdrawal ◽  
Group B

Abstract Background: At present, there is a higher complication rate after treatment of femoral neck fractures with three parallel hollow nails (PHN) in the young Pauwels type Ⅲ femoral neck fractures.For better effect,F-shape hollow nails(FHN) is used to treat femoral neck fractures.The purpose of this study is to compare the clinical efficacy of FHN and PHN and provide reference for clinical application.Methods: Thirty-eight consecutive patients admitted from January 2017 to January 2020 were selected for the study. According to random number table method, the patients were divided into two groups:group A (FHN) and group B (PHN). The gender, age, BMI, comorbidities, time from injury to operation and other general preoperative demographics were not statistically different (P>0.05). The data of the two groups can be comparable.The occurrence of avascular osteonecrosis of the femoral head (AVN), femoral neck shortening, hollow screw withdrawal was recorded in follow-up.Then, Harris hip score (HHS), pain visual analog score (VAS) of two group were obtained at the last follow-up. Results: The mean follow-up period after surgery was 21.4±10.1 (range, 14–29) months. There were 18 cases(mean age, 47.5±9.6) in group A, 20 cases (mean age, 48.6±10.1) in group B. There was no significant difference between the two groups in AVN, femoral neck shortening (P>0.05), the two groups had statistically significant differences in screw withdrawal (F=4.416, P<0.05). There was no significant difference in HHS and VAS between the two groups at the last follow-up (P>0.05).Conclusion: Three parallel hollow nails (PHN) and F-shape hollow nails (FHN) have similar short-term effects in the young Pauwels type Ⅲ femoral neck fractures, but the nail withdrawal rate of FNH is lower.

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