Efficacy of Reverse Triangle Screw Fixation in Patients Suffering from Femoral Neck Fractures

Abstract

Although the fractures of femoral neck are not so common, their accompanying complications are more frequent and important. This research aims at studying the results of reverse triangle screw fixation in patients suffering from femoral neck fractures in two groups with perfect and imperfect position of the mentioned screw. In a cohort study, 51 patients with femoral neck fracture appointed for the so-called reverse triangle screw fixation were divided into two perfect and imperfect groups considering surgeon comment on position of the screws. The patients were followed up for 12 months and the resulted outcomes were compared. There were 34 patients in the perfect group with mean age of 48.7 +/- 18.6 (18-80) and 17 patients in the imperfect group with mean age of 50.4 +/- 15.9 (19-80) years old. Both groups were the same considering underlying causes and fraction grades. The overall frequency of nonunion and avascular necrosis was 7.8 and 3.9%, respectively. These rates were 2.9 and 0% in the perfect group and 17.6 and 12.5% in the imperfect group, respectively (p > 0.05). The mean Harris hip score and motion range of the hip at different directions in the perfect group were substantially higher than those of the imperfect one. According to present results, position of the screws determined by the surgeon after operating the reverse triangle screw fixation in femoral neck fractures may significantly affect the prognosis of patients.

The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis

“…A total of 28 studies reported on both AVN incidence and the time interval between injury and surgery [ 16 , 17 , 22 , 25 , 27 , 28 , 29 , 30 , 32 , 33 , 36 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 49 , 51 , 52 , 54 , 55 , 56 , 57 , 59 , 65 , 67 ]. There was no significant correlation between AVN incidence weighted by sample size and time interval from injury to surgery, with a slope of weighted linear regression equal to −0.01 ( p = 0.843, R 2 = 0.01) ( Figure 3 ).…”

“… The relationship between AVN incidence and time from injury to surgery [ 16 , 17 , 22 , 25 , 27 , 28 , 29 , 30 , 32 , 33 , 36 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 49 , 51 , 52 , 54 , 55 , 56 , 57 , 59 , 65 , 67 ]. The size of the dot corresponds to the sample size of the study.…”