Fixed angle device comparison in young femoral neck fractures: Dynamic hip screw vs dynamic helical hip system

Marchand, Lucas S.; Butler, Bennet A.; McKegg, Phillip C.; DeLeon, Genaro; O’Hara, Nathan N.; Lebrun, Christopher; Sciadini, Marcus F.; Nascone, Jason W.; Slobogean, Gerard M.

doi:10.1016/j.injury.2021.11.016

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…At the same time, the trauma and the number of intraoperative uoroscopy are reduced, so the operation time and intraoperative radiation exposure of patients are reduced. Previous studies also found that femoral neck shortening was a common complication of FNF in the DHS group [23][24][25]. DCLS is locked into a triangular frame structure, which has good postoperative stability and can axially and evenly compress the fracture end.…”

Section: Discussionmentioning

confidence: 89%

Dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: A comparative study

Chang

Xiao

et al. 2022

Preprint

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Background: There is still a lack of consensus on which internal fixation method can better maintain the stability of femoral neck fractures (FNF), promote fracture healing, and avoid and reduce postoperative complications such as femoral head necrosis and nonunion. Therefore, the purpose of this study was to evaluate the clinical efficacy of the novel dynamic compression locking system (DCLS) versus dynamic hip screw (DHS) in the treatment of FNF.Methods: Fifty cases of FNF admitted from July 2018 to December 2020 were retrospectively analyzed. According to different treatment methods, they were divided into DCLS group (26 cases) and DHS group (24 cases). Baseline data, intraoperative and postoperative clinical data, complications, and Harris score were collected to evaluate the clinical efficacy. Results: All patients were followed up for 24 months, all of which were caused by falls. The baseline data of the two groups were comparable (P>0.05). There were not significant differences in the length of hospital stay and mobility between the two groups (P>0.05). The operation time, blood loss, incision length, fluoroscopy times and the degree of femoral neck shortening in the DCLS group were significantly less than those in the DHS group (all P<0.05). Harris score in the DCLS group was significantly higher than that in the DHS group (P<0.05). Complications of femoral head necrosis and nonunion in the DHS group were slightly higher than those in the DCLS group, but there was not statistical significance (P>0.05). Conclusion: DCLS is superior to DHS in the treatment of FNF, with advantages of less surgical trauma, simplified surgical procedures, lower radiation exposure dose for patients, good stability of internal fixation and better control of femoral neck shortening. However, there is not significant difference in fracture healing complications, which requires further study.

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Section: Discussionmentioning

confidence: 89%

Dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: A comparative study

Chang

Xiao

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…At the same time, the trauma and the number of intraoperative fluoroscopy are reduced, so the operation time and intraoperative radiation exposure of patients are reduced. Previous studies also found that femoral neck shortening was a common complication of FNF in the DHS group [23][24][25]. DCLS is locked into a triangular frame structure, which has good postoperative stability and can axially and evenly compress the fracture ends to promote fracture healing.…”

Section: Discussionmentioning

confidence: 92%

The efficacy of dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: a comparative study

Chang

Xiao

et al. 2022

BMC Musculoskelet Disord

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Background There is still a lack of consensus on which internal fixation method can better maintain the stability of femoral neck fractures (FNF), promote fracture healing, and reduce postoperative complications such as femoral head necrosis and nonunion. Therefore, the purpose of this study was to evaluate the clinical efficacy of the novel dynamic compression locking system (DCLS) versus dynamic hip screw (DHS) in the treatment of FNF. Methods Fifty cases of FNF from July 2018 to February 2020 were retrospectively analyzed. According to different treatment methods, they were divided into DCLS group (26 cases) and DHS group (24 cases). Baseline data, intraoperative and postoperative clinical data, reoperation rate, and Harris score were collected to evaluate the clinical efficacy. Results All patients were followed up for 24 months. All “fractures” were caused by fall. The baseline data of the two groups were comparable (P > 0.05). There weren’t significant differences in the length of hospital stay and mobility after two years postoperatively between the two groups (P > 0.05). The operation time, blood loss, incision length, fluoroscopy times and the degree of femoral neck shortening after two years postoperatively in the DCLS group were significantly less than those in the DHS group (all P < 0.05). Harris score after two years postoperatively in the DCLS group was significantly higher than that in the DHS group (P < 0.05). Although the reoperation rate in the DHS group was slightly higher than that in the DCLS group, it wasn’t statistical significance (P > 0.05). Conclusions Compared with DHS, DCLS in the treatment of FNF had less surgical trauma, shorter incision length, shorter operation time, lower radiation dose and higher Harris scores. Although the reoperation rate in the DHS group was slightly higher than that in the DCLS group, it wasn’t statistical difference. Further research is needed.

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“…Totally 4.5 million elderly people worldwide become disabled due to hip fractures every year, including about 1.7 million patients with FNF [ 1 , 2 ]. Such fractures are rarely treated conservatively, but usually treated by cannulated screw internal fixation, femoral head arthroplasty or total hip arthroplasty [ 3 , 4 ]. The type of fractures is one of the important factors determining the treatment programs.…”

Section: Introductionmentioning

confidence: 99%

Does Garden type I incomplete femoral neck fracture really exist in older adults? To evaluate the stability and consistency of Garden classification

et al. 2022

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Background Accurate classification of femoral neck fracture (FNF) is crucial for treatment plan and therapeutic outcomes. Garden classification is commonly used in the clinic, but its stability and consistency remain controversial. The aim of this study was to evaluate the stability and consistency of Garden classification based on X and CT images, and to analyze whether it is valid for Garden I in the elderly. Methods X-ray and CT images from 886 elderly patients with FNF were collected, four orthopaedic surgeons and four radiologists evaluated these images independently, and determined the fracture type based on Garden classification. Three months later, The exercise was repeated and the results were compared based on 4 types Garden classification (I, II, III and IV) and 3 types Garden classification (I + II, III and IV). Kappa was used to measure inter- and intraobserver agreement. The patients with Garden I incomplete FNF confirmed by 8 observers together based on images combined with medical history were compared with the intraoperative results. Results Four types Garden classification, there was little consistency inter- and intraobservers (Kappa from 0.18 to 0.43) based on X-ray images, while professors consistency (0.56 to 0.76) was higher than residents (0.28 to 0.35) based on CT. 3 types Garden classification showed almost perfect agreement inter- and intraobservers, which ranged from 0.76 to 0.90. Totally 52 patients were diagnosed as Garden I, 38 of whom underwent arthroplasty. All surgical cases showed complete fracture during operation. Conclusions There was low consistency and repeatability in 4 types Garden classification (I, II, III and IV), while 3 types Garden classification (I + II, III and IV) had high consistency among observers. In the elderly, all undisplaced femoral neck fracture may be Garden II, no Garden I.

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Fixed angle device comparison in young femoral neck fractures: Dynamic hip screw vs dynamic helical hip system

Cited by 7 publications

References 24 publications

Dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: A comparative study

Dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: A comparative study

The efficacy of dynamic compression locking system vs. dynamic hip screw in the treatment of femoral neck fractures: a comparative study

Does Garden type I incomplete femoral neck fracture really exist in older adults? To evaluate the stability and consistency of Garden classification

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