Incidence of and Factors Influencing Femoral Neck Shortening in Elderly Patients After Fracture Fixation with Multiple Cancellous Screws

Abstract

BackgroundTo study the incidence of and factors influencing “neck shortening” in elderly patients treated for femoral neck fractures using multiple cancellous screws.Material/MethodsOf the 197 femoral neck fracture cases treated via closed reduction and cancellous screws fixation from January 2006 to February 2010, 110 were followed up. Patient age, gender, operative time, implantation method, reduction quality, fracture type, bone mineral density, loading time, length of hospital stay, and Harris hip score 12 months after operation were recorded. The patients were divided into two groups (shortening and non-shortening) based on their X-ray performance during follow-up. The healing rates and Harris hip scores of the two groups were compared, and the influencing factors of femoral neck shortening were analyzed.ResultsOf the 110 cases followed up, 94.5% (104/110) were healed and neck shortening occurred in 41.8% (46/110) within 12.5 months (mean) after treatment. The Harris hip score of the shortening group was lower than that of the non-shortening group (78±17 vs. 86±23, p=0.048). The fracture healing rates of the two groups were not significantly different (p=0.068). The factors influencing neck shortening were significantly correlated with bone mineral density, patient age, gender, and type of fracture.ConclusionsThe incidence of neck shortening in elderly patients treated for femoral neck fracture using cancellous screws was high. Bone mineral density, patient age, gender, and type of fracture were the influencing factors of neck shortening.

Assessment of Screw Length of Proximal Humerus Internal Locking System (PHILOS) Plate for Proximal Humeral Fractures Using Three-Dimensional Computed Tomography Scan

“…These complications may result from the following factors. First, poor bone quality and thin cortices of the proximal humerus limit the tactile feedback of the drill bit [ 9 ], which makes selection of proper screw length difficult [ 10 ]. Second, the sphericity of the humeral head and diverging and converging locking screw vector make the exact localization of the screw tip using intraoperative fluoroscopy difficult [ 9 , 11 ], and make it hard to determine if the screws are inserted into the glenohumeral cavity.…”

Comparative Study between Results of Bipolar Hemiarthroplasty And Cannulated Screws in Management of Fracture Neck Femur in Old Age Group

“…On the other side, the reoperation rate of hemiarthroplasty patients in our study was 13.3%, while it was 1%-7% Joon Soon Kang et al, Philipp von Roth et al, studies [10,14] . Our mean Harris Hip Score was 74 in the fixation patients compared to 62 and 82 in Kasettiet al, Xiaobin et al, studies [15,16] . While our mean Harris Hip Score was 86.3 in hemiarthroplasty patients compared to 77 and 86.9 in Paul T.P.W.…”

Comparison of Ordinary Cannulated Compression Screw and Double-Head Cannulated Compression Screw Fixation in Vertical Femoral Neck Fractures

“…Sliding implants, such as OCCS, can lead to FNS, which causes abductor muscle weakness as a result of a decreased abductor moment arm [ 23 ]. Chen et al [ 24 ] reported that FNS occurred in 41.8% of elderly patients after fracture fixation with multiple cancellous sites and negatively affected postoperative joint function without affecting fracture union, whereas parallel implantation exhibited an increased shortening incidence compared with strong oblique implantation. To minimize this phenomenon, Weil et al [ 23 ] introduced the use of fully threaded screws and demonstrated that these screws decreased FNS after fixation of femoral neck fractures compared with OCCS.…”