scholarly journals Comparison of Femoral Neck System Versus Dynamic Hip System Blade for the Treatment of Femoral Neck Fracture in Young Patients: A Retrospective Study

2021 ◽  
Author(s):  
Zilu Ge ◽  
Wei Xiong ◽  
Yunfeng Tang ◽  
Dong Wang ◽  
Qian Fang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Femoral Head ◽  
Femoral Neck ◽  
Blood Loss ◽  
Femoral Neck Fracture ◽  
Young Patients ◽  
Incision Length ◽  
Pull Out ◽  
Neck Fracture ◽  
Operation Duration

Abstract Background: Femoral neck fracture is a common fracture in orthopedic practice. This study aimed to compare the clinical outcomes between the femoral neck system and dynamic hip system blade for the treatment of femoral neck fracture in young patients.Methods: This retrospective study included 43 and 52 patients who underwent treatment for femoral neck fracture with the femoral neck system and dynamic hip system blade, respectively, between August 2019 and February 2020. Operative indexes, including operation duration, blood loss, incision length, postoperative complications (femoral neck shortening, non-union, screw pull-out, femoral head necrosis), and Harris scale scores (preoperative and postoperative) were recorded and analyzed. Results: Compared to that with the dynamic hip system blade, the femoral neck system showed significantly less operation duration (femoral neck system vs dynamic hip system blade: 47.09±9.19 vs 52.90±9.64, P=0.004), less blood loss (48.53±10.69 vs 65.31±17.91, P<0.001), and shorter incision length (4.04±0.43 vs 4.93±0.53, P<0.001), but more expensive hospitalization charge (51224.14±2289.81 vs 41468.73±2431.05, P<0.001). Femoral neck shortening was significantly lower with the femoral neck system than with the dynamic hip system blade (3.93±2.40, n=39 vs 5.22±2.89, n=44, P=0.031). No statistical differences were observed between the two groups in nonunion, screw pull-out, and femoral head necrosis. In addition, the latest follow-up Harris scale score was significantly higher with the femoral neck system than with the dynamic hip system blade (92.3±4.5 vs 89. 9±4.9, P=0.015).Conclusion: The femoral neck system results in less trauma, less femoral neck shortening, and better hip joint function than the dynamic hip system blade for the treatment of femoral neck fracture in young patients.

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

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）

scholarly journals Intra-Articular Tranexamic Acid Injection During the Hip Hemi-Arthroplasty in Elderly Patients: A Retrospective Study

2018 ◽  
Vol 9 ◽  
pp. 215145931880385 ◽  
Author(s):  
Wei Liu ◽  
Huangdong Hui ◽  
Yunhai Zhang ◽  
Weilong Lin ◽  
Yongqian Fan
Keyword(s):  
Logistic Regression ◽  
Femoral Neck ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Femoral Neck Fracture ◽  
Mortality Rates ◽  
Transfusion Rate ◽  
Neck Fracture ◽  
Hemi Arthroplasty

Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA). Material and Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016. One hundred three consecutive patients undergoing HA under spinal or general anesthesia were included. Fifty-four and 49 patients received and did not receive intra-articular injection of TXA during the HA, respectively. After closing the capsule, 50 mL of a TXA solution at a concentration of 1 g/100 mL of saline was injected into joint capsule. We compared the following outcomes: preoperative hemoglobin (HB) level, postoperative day 1 HB level, postoperative day 3 HB level, the net reduction of HB level by postoperative day 3, transfusion rate, and 30- and 90-day postoperative mortality rates. In addition, we use logistic regression to analyze the factors affecting the transfusion rate. Result: Day 3 postoperative HB level and the net reduction in HB level within 3 days following surgery were 93.22 ± 11.70 g/L and 25.98 ± 6.29 g/L in TXA group, respectively, while were 87.10 ± 10.52 g/L and 35.44±8.61 g/L in no-TXA group. Transfusion rate was 9% (5/54) in TXA group and 24% (12/49) in no-TXA group, respectively. The differences were statistically significant between the both groups. Logistic regression indicated that the topical administration of TXA would reduce the risk for transfusion, while in male diabetes mellitus would increase the risk. There were no significant differences in the deep venous thrombosis, pulmonary embolism, and mortality rates of 30 and 90 days postoperatively ( P > .05). Discussion: Because of lower systemic absorption and a higher concentration in the wound, topical use of TXA is safer for elderly patients who may have renal or liver dysfunction. TXA at therapeutic concentration does not affect platelet count, platelet aggregation, or coagulation parameters, and is of value in elderly patients who take antiplatelet drug for secondary prevention of cardiovascular diseases. Conclusion: For patients between 80 and 100 years of age with femoral neck fracture undergoing HA, intra-articular injection of TXA may reduce the perioperative blood loss and transfusion rate without increasing risk of thrombosis.

scholarly journals Hip dislocation following the treatment of femoral neck fracture: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 248-251
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Borislav Dulic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Young Patients ◽  
Hip Dislocation ◽  
Full Weight Bearing ◽  
Limited Range Of Motion ◽  
Femoral Head Osteonecrosis ◽  
Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

scholarly journals Re-Recognition of Garden Index as a Criterion for Evaluating the Quality of Femoral Neck Fracture Reduction: An Imaging Study Based on Cadaver Specimens

2021 ◽  
Author(s):  
Leyi Cai ◽  
Wenjie Li ◽  
Wenhao Zheng ◽  
Jianshun Wang ◽  
Xiaoshan Guo ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Kirschner Wire ◽  
Imaging Study ◽  
Lateral View ◽  
Healthy Human ◽  
Rotational Displacement ◽  
Significant Difference ◽  
Neck Fracture

Abstract ObjectiveTo investigate whether the Garden index can determine the rotational displacement of femoral neck fracture. MethodsTen healthy human femoral specimens were obtained. A 2.0 mm diameter Kirschner-wire was placed in the center of the femoral head. The osteotomy was perpendicular in the middle of the femoral neck. The distal osteotomy surface was indicated the angle of rotation (pronation and supination to 90°, every 10° was an interval). The X-ray of anterior-posterior and lateral view was taken at different angles according to the mark. The Garden index and other relevant data were analyzed with the PCAS system. Meanwhile, the change of the area of the femoral head fovea at different rotation angles was observed. ResultsThere was no significant difference in the Garden index in 0~30° at pronation and supination position (P>0.05). In range of 40°~90°, there was a statistical difference in the Garden index (P<0.05). With the increase of the pronation angle, the area of the femoral head fovea is gradually reduced; as the angle of the supination increases, the area of the femoral head fovea is gradually increased. ConclusionThe Garden Index cannot accurately determine the rotational displacement of the femoral neck fracture during the pronation or supination range of 0~30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture.Level of EvidenceLevel V.

Total, hemi, or dual-mobility arthroplasty for the treatment of femoral neck fractures in patients with neurological disease

2022 ◽  
Vol 104-B (1) ◽  
pp. 134-141
Author(s):  
Peter H. J. Cnudde ◽  
Jonatan Nåtman ◽  
Nils P. Hailer ◽  
Cecilia Rogmark
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Arthroplasty ◽  
Neurological Disease ◽  
Dislocation Rate ◽  
Dual Mobility ◽  
Increased Risk ◽  
National Patient ◽  
Neck Fracture

Aims The aim of this study was to investigate the potentially increased risk of dislocation in patients with neurological disease who sustain a femoral neck fracture, as it is unclear whether they should undergo total hip arthroplasty (THA) or hemiarthroplasty (HA). A secondary aim was to investgate whether dual-mobility components confer a reduced risk of dislocation in these patients. Methods We undertook a longitudinal cohort study linking the Swedish Hip Arthroplasty Register with the National Patient Register, including patients with a neurological disease presenting with a femoral neck fracture and treated with HA, a conventional THA (cTHA) with femoral head size of ≤ 32 mm, or a dual-mobility component THA (DMC-THA) between 2005 and 2014. The dislocation rate at one- and three-year revision, reoperation, and mortality rates were recorded. Cox multivariate regression models were fitted to calculate adjusted hazard ratios (HRs). Results A total of 9,638 patients with a neurological disease who also underwent unilateral arthroplasty for a femoral neck fracture were included in the study. The one-year dislocation rate was 3.7% after HA, 8.8% after cTHA < 32 mm), 5.9% after cTHA (= 32 mm), and 2.7% after DMC-THA. A higher risk of dislocation was associated with cTHA (< 32 mm) compared with HA (HR 1.90 (95% confidence interval (CI) 1.26 to 2.86); p = 0.002). There was no difference in the risk of dislocation with DMC-THA (HR 0.68 (95% CI 0.26 to 1.84); p = 0.451) or cTHA (= 32 mm) (HR 1.54 (95% CI 0.94 to 2.51); p = 0.083). There were no differences in the rate of reoperation and revision-free survival between the different types of prosthesis and sizes of femoral head. Conclusion Patients with a neurological disease who sustain a femoral neck fracture have similar rates of dislocation after undergoing HA or DMC-THA. Most patients with a neurological disease are not eligible for THA and should thus undergo HA, whereas those eligible for THA could benefit from a DMC-THA. Cite this article: Bone Joint J 2022;104-B(1):134–141.

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