Comparison analysis of the operative treatment results of the femoral neck fractures using side-plate and compression screw and cannulated AO screws (original) (raw)
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Clinical analysis of internal fixation femoral neck fractures with two or three cannulated screws
Srpski arhiv za celokupno lekarstvo, 2021
Introduction/Objective. Angular stability and dynamic fixation are key factors to successful healing of femoral neck fractures. The objective was to evaluate the efficacy of internal fixation of femoral neck fractures with two parallel self-tapping antirotation screws (SAF) compared to standard, three cannulated cancellous screws (CCS) fixation. Methods. In total 100 fractures were retrospectively analyzed, divided in two groups in which two SAF screws were used in parallel (n = 50) or three standard screws in an inverted triangle configuration (n = 50). The groups were compared with operation time, time of consolidation, femoral neck shortening, Harris hip score and reoperation rates. Results. SAF parallel fixation group of patients achieved consolidation rate of 86% compared to 74% in CCS fixation group, without statistically significant difference between the examined groups (p > 0,05). Dynamization of implants was significantly positively correlated with the fracture healing ...
Dynamic Hip Screw for the Treatment of Femoral Neck Fractures: A Prospective Study with 96 Patients
ISRN Orthopedics, 2014
Objectives. To study the correlation between avascular necrosis and the demographics, time elapsed from fracture to surgery, quality of reduction, Garden classification, and the position of the screw following use of the dynamic hip screw (DHS) in the treatment of subcapital neck fractures. Methods. A prospective study of 96 patients with subcapital neck fractures was carried out in a faculty hospital. Patients underwent surgery with closed reduction and internal fixation with DHS. Results. There were 58% male and 42% female patients, with a mean age of 53 years (+/−14). In terms of Garden classification, 60% were Garden IV, 26% were Garden III, and 14% were Garden II. Nonunion was observed in three cases (3%) and was treated with valgus intertrochanteric osteotomy, in all cases leading to successful healing. Avascular necrosis was observed in 16% of patients. The positioning of the screw into the femoral head showed a significant correlation with necrosis. Conclusions. The incidence of necrosis in patients under the age of 50 years is twice as high as that in older patients. Displacement is a predictive factor regarding osteonecrosis and is associated with a high and anterior position of the screw in the femoral head. Level II of evidence. Study Type: therapeutic study.
Scientific Reports
To investigate the influence of various factors on the two outcome parameters “procedure - specific complication” (femoral head necrosis, infection, nonunion, femoral neck shortening, screw loosening, implant penetration) and “functional outcome” in patients with displaced and undisplaced femoral neck fracture treated by cannulated screw fixation. All cases of a femoral neck fracture, operated by cannulated screw fixation, in the period from December 2014 to December 2017 were included. The observation period of the included patients was 12 months. Information on their outcome was collected after evaluation of current x-ray images and on request from the responsible further treatment physician. Continuous data were presented as mean value ± standard deviation, categorical data as absolute and relative frequency. The effect of potential factors on endpoints was estimated with a multivariable logistic regression analysis and 95% confidence intervals calculated. The null hypothesis Odd...
Journal of Chittagong Medical College Teachers' Association
Background: Fracture neck of femur has always presented a great challenge to orthopedic surgeons due to its nature of going into non-union and osteonecrosis of femoral head even with the best fixation method and adequate reduction. Treatment of fracture neck of femur varies according to patient’s age and fracture pattern. Purpose of this study was to compare the outcome of DHS with side plate and de-rotation screw with multiple cannulated hip screws in fracture neck of femur in adult. Materials and methods: This quasi-experimental study was carried out in the Department of Orthopedic Surgery, Chittagong Medical College Hospital from July 2017 to June 2019. Sixty patients age limit between 18 to 55 years, with (AO/OTA 31-B) fracture was taken by purposive sampling technique as per set criteria and were treated either by DHS with side plate and de-rotation screw or by cannulated hip screws. Harris Hip Score was used for evaluation of functional outcome of surgery. Results: In this s...
Advanced Biomedical Research, 2013
Background: There is conflict of interest in the treatment of intracapsular femoral neck fractures and the outcomes. The aim of this study was evaluation the treatment outcomes of closed and open reduction and internal fixation with screw in 18-50-year-old patients. Materials and Methods: This clinical randomized study was conducted in Ayatollah Kashani Center in Isfahan from Nov 2010 to Nov 2011. In 42 patients selected in a randomized manner, fractures were reduced by closed reduction or open if necessary and C-ARM was controlled in AP and lateral plans. Movement range and femur pain severity were evaluated according to Visual analogue Scale (VAS) score at 3 and 6 months after surgery. Data were analyzed by SPSS 18. Chi-square, t-test, one-way analysis of variance (ANOVA), and descriptive statistics such as frequency distribution, mean, and mean deviation were used. Results: Forty-two patients with femoral neck fracture were treated by open [31 patients (73.8%)] or closed reduction [11 patients (26.2%)] and also osteosynthesis. Their mean age was 47.3 ± 9.8 years; 29 of them were males and 13 were females. Twelve patients had bad range of motion (ROM) (28.6%), 16 had intermediate ROM (38%), and 14 had good ROM (33.4%). After 6 months, 12 patients (28.6%) had bad ROM, 10 (23.8%) had intermediate ROM, and 20 (47.6%) had good ROM. There were 11 cases of non-union (35.5%) in the open reduction group and 4 in the closed group. Conclusion: This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered.
International Journal of Research in Orthopaedics, 2017
It is one of the more common injuries presenting to the emergency Department of Othopaedics OPD. It is usually seen in old age due to osteoporosis but in can also occurs in young age due to road traffic accident, sports related and fall from height. However, the optimal timing for surgical fixation of these fractures is still subject of debate in the literature. Femoral neck fracture is a common and severe injury in the elderly with associated high mortality and morbidity. The incidence of these fractures has increased with improvement in life expectancy and is expected to double ABSTRACT Background: Intracapsular fracture neck of femur has always presented great challenges to every Orthopaedic surgeons and it is remain a mystery whether to fix or to replace the fracture in the elderly. The aim of the study was to analyze the functional outcome of two widely used and accepted modalities of treatment in the age group 57-75 years, in Garden's type I and II fractures, namely (a) cannulated cancellous screw fixation(internal fixation) and (b) modular bipolar prosthetic replacement of the femoral head (hemiarthroplasty). Methods: The total 110 patients were including in the study from age groups 57-75 (mean age 66). The Garden classification of fracture neck of femur was used to evaluate the displacement of femoral neck fractures. Only grade 1 and 2 was included in the study. 55 patients were included in each group A and B. Osteosynthesis (fracture fixation) was carried out by closed reduction and insertion of cannulated cancellous screw and in other group hemiarthroplasty was done. Results: In group A 55 patient with fracture neck of femur was treated by osteosynthesis i.e. fixation using 02 or 03 cannulated cancellous screw and in group B, 55 patients with fracture neck of femur was treated by modular bipolar replacement hemiarthroplasty. In Group A out of 55, 41 patients union was achieved between 08 to 14 months (mean 11.5 month), 09 patients developed non-union even after 16 months and 05 patients develop collapse of head with AVN with shortening at end of 02 year, however in Group B out of 55 patients 51 patients started walking after 2 nd postoperative days, 02 patients developed infection, and 02 patients developed posterior dislocation. Conclusions: The fracture fixation may be tempting for fracture neck femur in age group 57-75 especially of Garden Type I but internal fixation put risk of non-union and AVN and second surgery may be required after few months or years if patients survive. Based on results in our study we therefore can conclude that in Garden Type I and II femur neck fractures in the patients between 57-75 years of age, hemiarthroplasty is the better modality of treatment.
2020
BackgroundA majority of femoral neck fractures are indicated for surgical treatment within the scope of applicable guidelines. However, the reported overall complication rate in elderly patients one year after hip fracture fixation was 33.3%. The purpose of this study was to clarify the incidence of complications one year after femoral neck fracture fixation using a sliding hip screw with a side plate device in elder than 65-year-old patients.MethodsWe studied the results of 115 cases of the internal fixation for femoral neck fractures in patients older than 65 years of age using the Twins device (HOYA Technosurgical Corporation, Tokyo, Japan). We could follow up 39 of these 115 cases at one year after fixation and retrospectively investigated complications in these patients. Research outcomes were mortality, surgical site infection (SSI), loss of reduction, aseptic necrosis, late segmental collapse (LSC), nonunion, periprosthetic fracture, reoperation, and recovery of walking abili...
International Journal of Health Sciences (IJHS), 2022
Background: Dynamic hip screws (DHS) and multiple cannulated cancellous screws (MCCS) are commonly used in anatomic reduction of femur neck fractures. However, there is limited information on the complications of various fixation methods. Objective: To assess the outcome of two different modalities of femur neck fracture fixation. Methodology: This prospective, randomized, comparative interventional study included 32 subjects with recent trauma. Patients were randomized to DHS and MCCS treatment groups (16 patients each). Post-surgical radiographs were obtained and clinical evaluation for deformities was performed using the Harris hip score (HHS). The duration of surgery, average blood loss, and complications were noted and assessed. Chi-square test was used to check the association between attributes. Two-sample t-test was employed to compare the mean between two groups. P≤0.05 indicated statistical significance. Results: A significant difference (p<0.001) between the 2 groups was noted with regard to patients' age. The median operative time for DHS and MCCS groups was 75 mins (range 60-90 mins) and 60 mins (range 50-70 mins), respectively. Average blood loss was more in DHS (200 mL) than in MCCS (120 mL) group. Majority of the patients (75%) in the DHS group showed excellent HHS results. The average duration for radiological union was 12 weeks and 13 weeks in DHS and MCCS groups, respectively. Femoral neck shortening was absent in DHS group. No significant difference in complications was observed between the groups. Conclusion: Fixation 7051 with DHS showed better clinical outcomes compared to MCCS. Both the groups had similar complications with avascular necrosis and non-union.