Comparison of early clinical results for the femoral neck system and cannulated screws in the treatment of unstable femoral neck fractures

Abstract Objective: To compare early clinical effects of the femoral neck system (FNS) and three cannulated screws for the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis with pair matching of 81 patients who received FNS or cannulated screw internal fixation for Pauwels type-3 femoral neck fracture in our hospital from January 2019 to December 2019 was conducted. Patients who received FNS were the test group, and those who received cannulated screws comprised the control group. Matching requirements were as follows: same sex, similar age and similar body mass index (BMI). A total of 30 pairs were successfully matched, and the average age was 53.84 years. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative visual analogue scale (VAS) score, time to walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all patients were followed up for 10-22 months. Those in the FNS group had lower postoperative VAS scores, earlier times to walking without crutches, higher Harris scores at the last follow-up and lower complication rates (P<0.05). However, intraoperative blood loss and hospitalization costs were greater in the FNS group (P<0.05). No statistically significant difference in operation time, hospital stay or femoral head necrosis rate was observed between the two groups (P>0.05).Conclusion: For patients with unstable femoral neck fractures, FNS has better clinical efficacy than cannulated screws, though it is also more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fractures.

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Comparison of early clinical results for the femoral neck system and cannulated screws in the treatment of unstable femoral neck fractures

10.21203/rs.3.rs-129837/v3 ◽

2021 ◽

Author(s):

Xiaoqiang Zhou ◽

Zhiqiang Li ◽

Renjie Xu ◽

Yuanshi She ◽

Xiangxin Zhang ◽

...

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Blood Loss ◽

Hospital Stay ◽

Clinical Efficacy ◽

Operation Time ◽

Femoral Neck Fractures ◽

Femoral Head Necrosis ◽

Cannulated Screws ◽

Intraoperative Blood Loss

Abstract Objective: To compare early clinical effects of the femoral neck system (FNS) and three cannulated screws for the treatment of patients with unstable femoral neck fractures. Methods: A retrospective analysis with pair matching of 81 patients who received FNS or cannulated screw internal fixation for Pauwels type-3 femoral neck fracture in our hospital from January 2019 to December 2019 was conducted. Patients who received FNS were the test group, and those who received cannulated screws comprised the control group. Matching requirements were as follows: same sex, similar age and similar body mass index (BMI). A total of 30 pairs were successfully matched, and the average age was 53.84 years. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative visual analogue scale (VAS) score, time to walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the groups. Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all patients were followed up for 10-22 months. Those in the FNS group had lower postoperative VAS scores, earlier times to walking without crutches, higher Harris scores at the last follow-up and lower complication rates (P<0.05). However, intraoperative blood loss and hospitalization costs were greater in the FNS group (P<0.05). No statistically significant difference in operation time, hospital stay or femoral head necrosis rate was observed between the two groups (P>0.05). Conclusion: For patients with unstable femoral neck fractures, FNS has better clinical efficacy than cannulated screws, though it is also more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fractures.

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Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures

10.21203/rs.3.rs-129837/v1 ◽

2020 ◽

Author(s):

Xiaoqiang Zhou ◽

Zhiqiang Li ◽

Renjie Xu ◽

Yuanshi She ◽

Xiangxin Zhang ◽

...

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Blood Loss ◽

Femoral Neck Fracture ◽

Complication Rate ◽

Operation Time ◽

Femoral Neck Fractures ◽

Cannulated Screws ◽

Intraoperative Blood Loss ◽

Neck Fracture

Abstract Objective: To compare the early clinical effects of femoral neck system and three cannulated screws in the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis was conducted on 81 patients who received FNS or cannulated screws internal fixation for Pauwels Type-3 femoral neck fracture in our hospital from January 2019 to December 2019. A pair-matched clinical research was performed. People who received FNS were test group and people received cannulated screws were control group. Matching requirements were as follows： the same gender, the similar age and the similar BMI. A total of 30 pairs were successfully matched, with an average age of 53.84 years old. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative VAS score, time walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the two groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all the patients were followed up for 10-22 months. Patients in the FNS group had lower postoperative VAS scores, earlier time to walk without crutches, higher Harris scores at the last follow-up and lower complication rate (P<0.05). However, intraoperative blood loss and hospitalization costs in the FNS group were more（P<0.05）. There was no statistically significant difference in operation time, hospital stay and femoral head necrosis rate between two group (P>0.05).Conclusion: For patients who were unstable femoral neck fracture, FNS has better clinical efficacy than cannulated screws, though FNS is more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fracture.Fund program: Key medical research project of Jiangsu Health Committee（K2019010）

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Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191784 ◽

2019 ◽

Vol 5 (3) ◽

pp. 458

Author(s):

Nikil Sanaba Paramesh ◽

Usman Taufiq

Keyword(s):

Femoral Neck ◽

Blood Loss ◽

Elderly Patients ◽

Operation Time ◽

Reoperation Rate ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Cerebrovascular Complications ◽

Uncemented Hemiarthroplasty ◽

Hip Function

Background: Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 60 years old.Methods: We searched PUBMED from inception to December 2012 for relevant randomized controlled trials (RCTs). Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR) and weighted mean differences (WMD) from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies.Results: Our control trial involved 132 patients (132 hips) who were eligible for the study. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31–0.76; p = 0.002), lower residual pain (OR = 0.43, 95%CI, 0.29–0.64; p<0.0001), less implant-related complications (OR = 0.15, 95%CI, 0.09–0.26; p<0.00001) and longer operation time (WMD = 7.43 min, 95% CI, 5.37–9.49 min; p<0.00001). No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss.Conclusions: Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02659-0 ◽

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.

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Recent Methods of Neck Femur Fixation A Systematic review and meta-analysis

QJM ◽

10.1093/qjmed/hcab104.017 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Salem Eid ◽

Ahmed Mohamed Mohasseb ◽

Ramy Mohamed Mohamed El-Bahnasy

Keyword(s):

Systematic Review ◽

Femoral Head ◽

Femoral Neck ◽

High Energy ◽

Femoral Neck Fractures ◽

Final Outcome ◽

Cannulated Screws ◽

Fixed Angle ◽

Femur Fractures ◽

Femoral Head Osteonecrosis

Abstract Background Femoral neck fractures in adults younger than age 50 years are uncommon and often the result of high energy trauma. They account for only 2-3% of all femoral neck fractures. Femoral neck fractures are associated with aging and osteoporosis and can occur after relatively trivial trauma in elderly patients. femoral neck fractures are associated with higher incidences of femoral head osteonecrosis and nonunion. Fixation options include cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. A systematic review of literature done to evaluate which technique is better. Methods After literature search thirteen articles were found and were reviewed to evaluate final outcome of fixation of neck femur fractures by cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. Results After evaluation of all studies the incidence of nonunion, osteonecrosis of femoral head, implant failure & revesion surgery is lower in comparing Targon plate with multiple cannulated screws while we need further studies for application of non parallel screws and medial plate. Conclusion Targon plate recorded low incidence of complications in the final outcome in comparison with multiple cannulated screw while we need further studies for application of Non parallel screws and medial plate.

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Comparison of Perioperative Outcomes in Open and Laparoscopic Radical Cystectomy with Modified Ureterosigmoidostomy (MainzII): A Retrospective Analysis

10.21203/rs.3.rs-805660/v1 ◽

2021 ◽

Author(s):

Bin Zhang ◽

Yang He ◽

Duo Zheng ◽

Junyao Liu ◽

Peng Qi ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Radical Cystectomy ◽

Urinary Diversion ◽

Open Surgery ◽

Operation Time ◽

Laparoscopic Group ◽

Postoperative Hospital Stay ◽

Intraoperative Blood Loss

Abstract Background: To analyze perioperative conditions and long-term efficacy of open modified ureterosigmoidostomy urinary diversion (OMUUD) in patients with bladder cancer who underwent open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC).Methods: In this retrospective study, the clinical data of patients who underwent open and laparoscopic radical cystectomy plus open modified ureterosigmoidostomy urinary diversion in our hospital were collected from January 2011 to December 2019. In addition, perioperative data of 56 patients who underwent ORC and OMUUD were compared with those of 118 patients who underwent laparoscopic radical cystectomy (LRC) plus OMUUD. A long-term follow-up was performed to compare the overall survival (OS) and progression-free survival (PFS) rate between the two groups.Results: Results showed that there was no significant difference between ORC+OMUUD group and LRC+OMUUD group in terms of gender, age, body index, pre-operative ASA grade, history of transurethral resection of bladder tumor (TURBT) before surgery, tumor T stage, lymph node dissection range, pathological grade, and positive postoperative surgical margin. The mean operation time in the open group was shorter than that in the laparoscopic group （P<0.001）. Moreover, the estimated intraoperative blood loss（P<0.001）and postoperative hospital stay（P=0.023）were better in the laparoscopic group than in the open group. The incidence of complications between 30 days (P=0.665) and 90 days (P=0.211) time-points after surgery was not significantly different. Similarly, the OS (P=0.237) and PFS (P=0.307) between the two groups were comparable.Conclusion: This study shows that the LRC group has long operation time, but less estimated intraoperative blood loss, short postoperative hospital stay, small trauma, and fast postoperative recovery compared to open surgery. Moreover, the incidence of complications at 30 - and 90-days postoperation, as well as the OS and PFS is not different between laparoscopy and open surgery.

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Short-Term Clinical Efficacy of Femoral Neck System Versus Multiple Cannulated Compression Screws in the Treatment of Garden III and IV Femoral Neck Fractures

10.21203/rs.3.rs-1229275/v1 ◽

2022 ◽

Author(s):

Xuefeng Zhou ◽

Sichao Gu ◽

Li Li ◽

Lei Xu ◽

Xujin Wang ◽

...

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Clinical Efficacy ◽

Weight Bearing ◽

Operation Time ◽

Femoral Neck Fractures ◽

Teaching Hospitals ◽

Harris Hip Score ◽

Clinical Report ◽

Short Term

Abstract Femoral neck system (FNS) , as a novel minimally invasive internal fixation device, has been gradually applied in the treatment of femoral neck fracture.However, there are few related clinical studies on FNS at present, especially there is no clinical report on FNS in treating GardenIII and IV femoral neck fractures. The aim of the present study was to compare the short-term clinical efficacy of FNS and multiple cannulated compression screws (MCCS) in the treatment of Garden III and IV femoral neck fractures. The data of 78 patients with femoral neck fracture who were admitted to three teaching hospitals affiliated to Anhui Medical University and received internal fixation with FNS and MCCS from June 2019 to December 2020 were collected for a retrospective study. There were 39 patients in both the FNS and MCCS groups. The basic data, perioperative data were recorded and compared between the two groups of patients. The results of the study are encouraging. The operation time was shorter in FNS group than that in MCCS group (p<0.001). The post-operative partial and complete weight-bearing time was earlier in FNS group than that in MCCS group (p<0.001). The Harris hip score in FNS group was higher than that in MCCS group (p<0.001). The incidence rate of lateral thigh irritation in FNS group and MCCS group was 0 (0/39) and 33.3% (13/39), respectively (χ2=15.600, p<0.001). The length of femoral neck shortening was significantly shorter in FNS group than that in MCCS group (t=-5.093, p<0.001). In conclusion, The application of FNS for Garden III and IV femoral neck fractures can shorten the operation time, reduce the frequency of intraoperative fluoroscopy, and facilitate the recovery of hip joint function, so it provides a novel choice for the treatment of Garden III and IV femoral neck fractures in young people.

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Outcomes of conversion THA after failed porous tantalum implant for osteonecrosis of the femoral head: a comparative matched study

Hip International ◽

10.1177/1120700019863036 ◽

2019 ◽

Vol 30 (6) ◽

pp. 703-710

Author(s):

Jinhui Ma ◽

Bailiang Wang ◽

Debo Yue ◽

Wei Sun ◽

Weiguo Wang ◽

...

Keyword(s):

Femoral Head ◽

Blood Loss ◽

Operation Time ◽

Additional Treatment ◽

Harris Hip Score ◽

Primary Group ◽

Intraoperative Blood Loss ◽

Previous Surgery ◽

Porous Tantalum ◽

Joint Preserving Surgery

Background: As a joint-preserving surgery, porous tantalum implantation (PTI) provides an additional treatment option for osteonecrosis of the femoral head (ONFH). However, conversion to a total hip arthroplasty (THA) after failed PTI is considered a challenging procedure. The purpose of this study was to compare the clinical and radiologic outcomes and complications of THA after failed PTI with those of primary THA without any previous surgery for ONFH. Methods: This retrospective study included 32 patients undergoing THA after failed PTI and 25 age, sex, and body mass index matched patients who underwent primary THA without any previous surgery for ONFH between December 2009 and March 2014. All patients were followed for at least 36 months. The postoperative clinical and radiological evaluations were based on Harris Hip Score (HHS) and plain radiographs. The independent sample test and the chi-square test were used for the statistical analysis. Results: The HHS in the PTI group was similar to that in the primary group at the latest follow-up ( p = 0.274), but longer operation time and greater intraoperative blood loss were observed in the PTI group ( p < 0.001, respectively). No significant differences in radiological parameters and postoperative complications were found between the 2 groups ( p > 0.05). Conclusions: THA after PTI showed similar clinical and radiological outcomes to primary THA except for longer operation time and greater intraoperative blood loss.

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Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Neurosurgery ◽

10.1227/neu.0b013e3181eda61d ◽

2010 ◽

Vol 67 (4) ◽

pp. 941-948 ◽

Cited By ~ 30

Author(s):

Jiaping Li ◽

Shenming Wang ◽

Chishing Zee ◽

Jianyong Yang ◽

Wei Chen ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Carotid Body ◽

Operation Time ◽

Class Ii ◽

Preoperative Embolization ◽

Intraoperative Blood Loss ◽

Class Iii ◽

Group I ◽

Group Ii

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

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