Immediate Weight-Bearing after Internal Fixation of Femoral Neck Fractures Using Von Bahr Screws:Preliminary Report of a Prospective Clinical Trial

1977 ◽  
Vol 48 (6) ◽  
pp. 659-664 ◽  
Author(s):  
Odd Søreide ◽  
Anders Mølster ◽  
Tor Steinar Raugstad
Keyword(s):  
Clinical Trial ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Prospective Clinical Trial

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

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.

scholarly journals Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Zhu ◽  
Hongzhi Hu ◽  
Xiangtian Deng ◽  
Yiran Zhang ◽  
Xiaodong Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Calibration Curve ◽  
Weight Bearing ◽  
Femoral Neck Fractures ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Abstract Objective We aimed to evaluate risk factors and develop a nomogram for reoperation after internal fixation of nondisplaced femoral neck fractures (FNFs) in elderly patients. Methods We conducted a retrospective study involving a total of 255 elderly patients who underwent closed reduction and internal fixation with cannulated screw system for nondisplaced FNFs between January 2016 and January 2019. We collected data on demographics, preoperative radiological parameters, surgery, serum biochemical markers, and postoperative rehabilitation. In addition, we performed univariate and multivariate logistic regression analyses to determine independent risk factors for reoperation, and then developed a nomogram to assess the risks of reoperation. Besides, discriminative ability, calibration, and clinical usefulness of the nomogram were evaluated using the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. We employed bootstrap method to validate the performance of the developed nomogram. Results Our analysis showed that among the 255 patients, 28 (11.0%) underwent reoperation due to osteonecrosis of the femoral head (14 cases), mechanical failure (8 cases) or nonunion (6 cases). All of the 28 patients underwent conversion surgery to arthroplasty. The multivariate logistic regression analysis demonstrated that preoperative posterior tilt angle ≥ 20°, Pauwel’s III type, younger patients, preoperative elevated levels of alkaline phosphatase (ALP), preoperative hypoalbuminemia, and early postoperative weight-bearing were independent risk factors for reoperation. In addition, the C-index and the bootstrap value of the developed nomogram was 0.850 (95% CI = 0.803–0.913) and 0.811, respectively. Besides, the calibration curve showed good consistency between the actual diagnosed reoperation and the predicted probability, while the DCA indicated that the nomogram was clinically valuable. Conclusions Our analysis showed we successfully developed and validated a nomogram for personalized prediction of reoperation after internal fixation of nondisplaced FNFs in elderly patients. This model would help in individualized evaluation of the need for reoperation and inform strategies aimed at eliminating the need for the reoperation.

scholarly journals Valgus Impacted Femoral Neck Fractures: Surgery or Non-Operative Approach?

2021 ◽  
Author(s):  
Arvin Najafi ◽  
Mohsen Tavakoli ◽  
Danoosh Zargar ◽  
Dorsa Hadavi ◽  
Ehsan Seif ◽  
...  
Keyword(s):  
Treatment Group ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Operative Treatment ◽  
Weight Bearing ◽  
Operative Management ◽  
Femoral Neck Fractures ◽  
Significant Difference ◽  
Non Operative Management ◽  
Partial Weight

Background: Non-operative management of valgus impacted femoral neck fracture leads to prolonged bed rest which may lead to deep vein thrombosis. The preferred method is the internal fixation because of pain control, enhanced mobilization, and better fracture healing but fails in older patients and individuals with medical comorbidities. The present study aims to assess the functional outcomes after the internal fixation or the non-operative management. Methods: A retrospective cohort study was conducted at a Level I trauma center from January 2013 to December 2019 on all patients with valgus-impacted femoral neck fractures [Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association Classification (AO/OTA 31-B1)]. Overall, 81 patients were managed operatively with three partially threaded, cannulated screws in a parallel configuration and 21 patients were managed non operatively with instant mobilization, physical therapy, and partial weight-bearing protocol. Results: 6 (28.0%) patients in the non-operative group and 3 (4.0%) cases in the operative group experienced fracture displacement (P < 0.001). 48 (59.2%) patients of the operative treatment group returned to baseline ambulatory function at 3 months, while this figure was 43.0% in the non-operative treatment group, not significantly different (P = 0.100). There was no significant difference in the mortality rates at one month and three months between the two groups (2 patients in each group, P = 0.140).  Conclusion: The ideal treatment of valgus-impacted femoral neck fractures is still controversial. The main purpose in the treatment of hip fractures is to return the patient to functional level equal to the level he or she was before the fracture. Surgically treated patients had lower failure rates in comparison with the other group.  

scholarly journals Pediatric Femoral Neck Fractures

2014 ◽  
Vol 13 (2) ◽  
pp. 198-204
Author(s):  
Ramji Lal Sahu
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Weight Bearing ◽  
Medical Science ◽  
Delayed Union ◽  
Femoral Neck Fractures ◽  
Full Weight Bearing ◽  
Coxa Vara ◽  
Anatomical Reduction ◽  
Mean Time

Introduction: Femoral neck fractures are rare injuries in children, but the high incidence of long term complications make it an important clinical entity. The aim of this prospective study was to analyze the clinical outcomes of pediatric femur neck fractures. Methods: The study included 16 children (10 boys and 6 girls) who sustained femoral neck fractures and completed an average follow-up of 28 months. The children were treated with anatomical reduction and internal fixation with partially threaded cancellous screws. The outcomes were clinically and radio logically assessed for fracture healing, joint movements and implant failure. Results: The mean age of included patients was 10 years (range, 6 to 16 years) and the average followup was 28 months (range, 17 -48 months). Coxa- vara was the most common complication Other complications included nonunion associated with Partial a vascular necrosis and delayed union was seen in one case but later on it had been corrected. Two cases of slight coxa vara were seen radiologically but clinically patients had no problem in walking and daily activities. All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) except two cases. Full weight bearing was possible in a mean time of 8.8 weeks. The results were excellent in 68.75% and good in 18.75% patients. Conclusions: We conclude that the early operation using anatomical reduction and internal fixation of pediatric femoral neck fracture offers the best results and provide early healing less complication with good results and is economical. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18303 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.198-204

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