Fixation of Basicervical Fractures of the Proximal Femur

Blair, Benjamin; Koval, Kenneth J.; Kummer, Frederick J.; Zuckerman, Joseph D.

doi:10.1097/00005131-199304000-00093

Cited by 12 publications

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“…Approaches to treating displaced femoral‐neck fractures remain controversial, especially in unstable femoral neck fractures. The most common implants used for fixation of femoral neck fractures today include cannulated screws and sliding hip screws; however, complications including nonunion, varus collapse, shortening, and osteonecrosis remain a problem, with rates up to 27% 36 . Novel technologies have been developed in recent years to improve and combine concepts used in classic treatments of femoral neck fractures, such as the Aesculap Targon FN, Swemac Dynaloc and the Smith and Nephew Conquest 8‐12 .…”

Section: Discussionmentioning

confidence: 99%

“…SCAP-FN constructs demonstrated greater 5 mm failure loads and axial stiffness than DHS + DS and 3CS constructs in Sawbones simulating a Pauwels III femoral neck fracture; (2) SCAP-FN constructs had the smallest displacement after 30,000 cycles among the three implants; and (3) SCAP-FN implants showed greater torsional stiffness than DHS + DS and 3CS implants.Approaches to treating displaced femoral-neck fractures remain controversial, especially in unstable femoral neck fractures. The most common implants used for fixation of femoral neck fractures today include cannulated screws and sliding hip screws; however, complications including nonunion, varus collapse, shortening, and osteonecrosis remain a problem, with rates up to 27% 36. Novel technologies have been developed in recent years to improve and combine concepts used in classic treatments of femoral neck fractures, such as the Aesculap Targon FN, Swemac Dynaloc and the Smith and Nephew Conquest [8][9][10][11][12].…”

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Novel slide compression anatomic plates of the femoral neck for treating unstable femoral neck fracture: A biomechanical study

Yin

et al. 2022

Journal Orthopaedic Research

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To compare the biomechanical stability of slide compression anatomic plates of the femoral neck, cannulated compression screws and dynamic hip screws with derotation screws for stabilizing unstable femoral neck fractures (Pauwels angle = 70°). Pauwels III femoral neck fractures were created on 45 Sawbones femurs and randomly assigned to three implant groups (1:1:1). The biomechanical stability of all Sawbones in each treatment group was evaluated with three tests. First, in the static loading test, the load–displacement curve, vertical stiffness (load/vertical displacement [N/mm]) and 5 mm failure load were recorded. Second, in the incremental cyclic loading test (700, 1000, and 1400 N), the cyclic−displacement curve and the displacement of the fragments were recorded. Third, in the torsion test, the torsional rigidity, maximum torque, and torsional angle corresponding to the maximum torque were recorded. The static compression test showed that slide compression anatomic place‐femoral neck (SCAP‐FN) had the largest vertical stiffness (275 ± 11 N/mm, p < 0.01) and 5 mm failure load (1232 ± 156, p < 0.01). The cyclic loading test showed that SCAP‐FN had the lowest change in displacement after 30000 cycles of loading. The torsional stiffness and the maximum torque followed the order SCAP‐FN > dynamic hip screw systems (DHS) + derotational screw (DS) > CCS, and the torsional angle corresponding to the maximum torque followed the order SCAP‐FN < DHS + DS < CCS. The SCAP‐FN construct provides stiffness and stability compared with other standard fixation techniques (3CS and DHS + DS). The fixation strategy of SCAP‐FN might be sufficient for clinical use, indicating studies in the human body are warranted.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Novel slide compression anatomic plates of the femoral neck for treating unstable femoral neck fracture: A biomechanical study

Yin

et al. 2022

Journal Orthopaedic Research

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“…Sin embargo, algunos autores, basados en estudios biomecánicos, prefieren el tornillo deslizante de cadera en las fracturas con trazos inestables, debido a su mejor comportamiento respecto a los tornillos canulados de 6,5 mm. [22][23][24] en nuestra serie, se evaluaron solo los casos en los que se utilizaron tornillos canulados de 6,5 mm con rosca de 16 mm o 32 mm, y se excluyeron dos casos en los que se prefirió el tornillo deslizante de cadera, debido la verticalidad del trazo.…”

Section: 18-20unclassified

Osteosíntesis con tornillos canulados en fracturas mediales de cadera. Factores pronósticos y resultados en 93 casos

Pereira¹,

Calvo²,

Lugones³

et al. 2014

Rev. Asoc. Arg. Ort. y Traumatol

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<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span><strong>Resumen</strong><br /> Introducción: </span><span>La reducción y osteosíntesis con tornillos canulados en las fracturas mediales de cadera constituye una opción terapéutica válida. nuestro objetivo es identificar factores pronósticos y grupos de riesgo.<br /> </span></p><p><span><strong>Materiales y Método</strong>s: </span><span>Se estudiaron retrospectivamente 93 fracturas intracapsulares de cadera tratadas con fijación interna con tornillos canulados de 6,5 mm, entre junio de 1995 y marzo de 2011 (71 no desplazadas y 22 desplazadas).<br /> </span></p><p><span><strong>Resultados</strong>: E</span><span>n 82 de los 93 casos, se observó la consolidación de la fractura. Once pacientes tuvieron complicaciones (5 seudoartrosis y 6 necrosis avascular). En el grupo de fracturas no desplazadas, la consolidación fue del 95,8% y, en el grupo de las desplazadas, del 63,6%. en este último grupo, si presentaban conminución, la consolidación fue del 50% y, en el grupo sin conminución, fue del 71,4%. El índice de consolidación fue del 46,1% con reducción cerrada y del 88% con reducción abierta. </span></p><p><span><strong>Conclusión</strong>:</span><span>La reducción cerrada y la osteosíntesis con tornillos canulados en fracturas impactadas o no desplazadas del cuello del fémur, cualquiera sea la edad del paciente, resulta un método exitoso. En las fracturas desplazadas, en cambio, la consolidación sin necrosis es menos previsible, por lo que su indicación deberá ser más meditada.</span></p><p> </p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p> </p></div></div></div></div></div></div>

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“…Because of its anatomical nature, basicervical femoral neck fracture remains a controversial fracture type, being regarded as an intracapsular or extracapsular fracture 9 . Internal fixation using a dynamic hip screw (DHS) or an intramedullary nail has been performed as a treatment method for these fractures 9,10 . Some biomechanical studies reported that DHS and intramedullary nails achieved higher fixation strengths compared to cannulated screws in basicervical femoral neck fracture 9,11 .…”

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confidence: 99%

“…Internal fixation using a dynamic hip screw (DHS) or an intramedullary nail has been performed as a treatment method for these fractures 9,10 . Some biomechanical studies reported that DHS and intramedullary nails achieved higher fixation strengths compared to cannulated screws in basicervical femoral neck fracture 9,11 . The femoral neck system (FNS), which is a minimally invasive implant recently developed for the treatment of femoral neck fractures, including basilar, transcervical, and subcapital fractures, combines the advantages of angular stability with the minimally invasive surgical technique 12 .…”

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Biomechanical comparison of the femoral neck system and the dynamic hip screw in basicervical femoral neck fractures

Moon¹,

Lee

Hwang

et al. 2022

Sci Rep

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The purpose of this study was to compare the fixation stability of proximal fragments and the mechanical characteristics in proximal femur models of basicervical femoral neck fracture fixed by the femoral neck system (FNS) versus the dynamic hip screw. The mean axial stiffness was 234 ± 35 N/mm in the FNS group and 253 ± 42 N/mm in the DHS group, showing no significant difference (p = 0.654). Mean values for x-axis rotation, y-axis rotation, and z-axis rotation after cycle load were 2.2 ± 0.5°, 6.5 ± 1.5°, and 2.5 ± 0.6°, respectively, in the FNS group and 2.5 ± 0.7°, 5.8 ± 2.1°, and 2.2 ± 0.9°, respectively, in the DHS group, showing no significant differences (p = 0.324, p = 0.245, and p = 0.312, respectively). The mean values of cranial and axial migration of screws within the femoral head were 1.5 ± 0.3 and 2.1 ± 0.2 mm, respectively, in the FNS group and 1.2 ± 0.3 and 2.4 ± 0.3 mm, respectively, in the DHS group, showing no significant differences (p = 0.425 and p = 0.625, respectively). The average failure load at vertical load was 1342 ± 201 N in the FNS group and 1450 ± 196 N in the DHS group, showing no significant difference (p = 0.452). FNS fixation might provide biomechanical stability comparable to that of DHS for treating displaced basicervical femoral neck fractures in young adults.

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Fixation of Basicervical Fractures of the Proximal Femur

Cited by 12 publications

References 0 publications

Novel slide compression anatomic plates of the femoral neck for treating unstable femoral neck fracture: A biomechanical study

Novel slide compression anatomic plates of the femoral neck for treating unstable femoral neck fracture: A biomechanical study

Osteosíntesis con tornillos canulados en fracturas mediales de cadera. Factores pronósticos y resultados en 93 casos

Biomechanical comparison of the femoral neck system and the dynamic hip screw in basicervical femoral neck fractures

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