Internal fixation of fragility fractures<b>of the femoral neck</b>

Basso, Trude

doi:10.3109/17453674.2015.1056702

Cited by 11 publications

(12 citation statements)

References 140 publications

(211 reference statements)

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“…Confirming the results of in vitro biomechanical studies of cadaver femurs, 31 the current study demonstrated that compression screws permit fracture-site micromotion under loading. This observation supports the assertion that our clinical DL-RSA setup generated sufficient loading at the hip.…”

supporting

confidence: 82%

Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Finnilä

Moritz

Strandberg

et al. 2018

Journal Orthopaedic Research

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We examined the feasibility of radiostereometric analysis (RSA) in the assessment of the initial stability of internally fixed femoral neck fractures. The study included 16 patients (mean age 73 years). During surgery, multiple RSA‐beads were inserted on both sides of the fracture. Radiographs for RSA were taken in the supine position within the first 3 days and 6, 12, 24, and 52 weeks after surgery. To detect any inducible motion at the fracture‐site, radiographs for RSA were taken with the patient resting or applying a load through the fracture. Fracture loading was achieved by the patient pressing the ipsilateral foot as much as tolerated on a force plate while providing a counterforce through both hands. Micromotion exceeding the precision values of RSA (≥0.3 mm for the translation vector and/or ≥1.2 degrees for the rotation vector) was considered significant. Permanent three‐dimensional fracture‐site displacement was also recorded. Voluntary loading induced fracture‐site micromotion, which exhibited a dichotomous distribution. In patients with uncomplicated fracture union, inducible micromotion was detectable only at baseline—if at all. Conversely, fractures that developed a nonunion were characterized by the continuation of inducible micromotion beyond baseline. Permanent fracture‐site displacement was, on average, nearly an order of magnitude greater than the inducible micromotion. Fracture unions were characterized by the cessation of permanent fracture‐site displacement by 12 weeks. Nonunions presented as outliers in permanent fracture‐site displacement. Large‐scale studies are warranted to evaluate whether the detection of inducible micromotion beyond baseline could serve as an indicator of insufficient fixation stability. © 2018 The Authors. Journal of Orthopaedic Research ® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society.

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supporting

confidence: 82%

Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Finnilä

Moritz

Strandberg

et al. 2018

Journal Orthopaedic Research

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“…However, because the three cannulated screws are not related to each other; the position of the screws are easily affected by subjective and objective factors of the operator. So its resistance to vertical shear and torsion is relatively poor, which can lead to loosening and redisplacement of fracture end, femoral head necrosis, nonunion, and femoral neck shortening [24,25]. And in the process of healing, lack of sustained and effective solid support will affect the rehabilitation training of the affected limb and growth of the fractures [9].…”

Section: Discussionmentioning

confidence: 99%

Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study

Shu

Xiao

Bei

et al. 2020

BMC Musculoskelet Disord

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Background: Femoral neck fractures are one of the problems in clinical treatment. The prognosis is uncertain. Currently, No internal fixation method is superior to other internal fixation methods in the treatment of femoral neck fractures. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic compression locking system (DCLS) and multiple cannulated compression screws(MCCS) in the treatment of femoral neck fractures. Methods: A prospective analysis of 54 cases of femoral neck fractures treated with either a DCLS (n = 28) or MCCS (n = 26) was conducted between December 2015 and November 2017 in authors' hospitals. The perioperative and postoperative parameters of the two groups were recorded and evaluated. Results: Fifty-four patients were followed up for 24-47 months. The etiology was caused by a fall. There was no significant difference in follow-up time, operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the two groups (all P > 0.05). The Harris score, fracture healing time, femoral neck shortening, partial weight-bearing time and complete weight-bearing time were significantly better in the DCLS group than in the MCCS group (all P < 0.05). The fracture healing rate in the DCLS group was higher than that in the MCCS group. Conclusions: The DCLS and MCCS might be equally effective in terms of operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the treatment of femoral neck fractures. However, the DCLS is superior to the MCCS in Harris score, fracture healing time, femoral neck shortening, weight-bearing time and fracture healing rate. So, DCLS deserves further study.

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“…However, because the three cannulated screws are not related to each other; the position of the screws are easily affected by the subjective and objective factors of the operator. So its resistance to vertical shear and torsion is relatively poor, which can lead to loosening and re-displacement of fracture end, femoral head necrosis, nonunion, and femoral neck shortening [23,24] . And in the process of healing, the lack of sustained and effective solid support affects the rehabilitation training of the affected limb and the growth of fractures [9].…”

Section: Discussionmentioning

confidence: 99%

Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study

Xiao¹,

Bei

Tao³

et al. 2020

Preprint

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Background: Femoral neck fractures are one of the problems in orthopedic treatment. The prognosis is uncertain. Currently, there is no one internal fixation for the treatment of femoral neck fractures that shows superiority over other internal fixations. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic compression locking system （DCLS）and multiple cannulated compression screws（MCCS） in the treatment of femoral neck fractures.Methods: A prospective analysis of 54 cases of femoral neck fractures treated with either a DCLS (n=28) or MCCS (n=26) was conducted between December 2015 and November 2017 in authors’ hospitals. The perioperative and postoperative parameters of the two groups were recorded and evaluated.Results: Fifty-four patients were followed up for 24-47 months. The etiology was caused by a fall. There was no significant difference in follow-up time, operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the two groups (P> 0.05). The Harris score, fracture healing time, femoral neck shortening, partial weight-bearing time and complete weight-bearing time were significantly better in the DCLS group than in the MCCS group (P< 0.05). The fracture healing rate in the DCLS group was higher than that in the MCCS group.Conclusion: The DCLS and MCCS might be equally effective in terms of operation time, incision length, surgical blood loss, the incidence of perioperative and postoperative healing complications, and mobility in the treatment of femoral neck fractures. However, the DCLS is superior to the MCCS in Harris score, fracture healing time, femoral neck shortening, weight-bearing time and fracture healing rate. So, DCLS deserves further study.

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Internal fixation of fragility fracturesof the femoral neck

Cited by 11 publications

References 140 publications

Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study

Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study

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