Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures

Walsum, A. D. P. van; Vroemen, J.P.A.M.; Janzing, H; Winkelhorst, T.; Kalsbeek, J H; Roerdink, W.H.

doi:10.1007/s00068-016-0659-4

Cited by 17 publications

(9 citation statements)

References 18 publications

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“…In a prospective multicenter cohort study in the Netherlands 172 patients with an undisplaced FNF were treated with the DLBP. The results of this study showed a failure rate of 4% [13]. Another recent prospective cohort study of 106 patients of 60 years and younger with displaced FNF demonstrated a DLBP related failure rate of 13.2% [14].…”

Section: Introductionsupporting

confidence: 43%

“…The DLBP is a new implant that is on the market since 2010. Today's evidence for this implant is not as widespread as for the DHS, but the results from (non randomized) earlier studies are promising [13,14]. The outcome of the DEFENDD trial will provide high-level evidence of which implant is favorable for the treatment of femoral neck fractures in young patients (≤65 years).…”

Section: Discussionmentioning

confidence: 99%

“…The expandable impaction anchors lock the blade in the femoral head and prevent perforation and backing out of the implant and further augment the rotational stability. The DLBP is now marketed as the Gannet [13].…”

Section: Dynamic Locking Blade Platementioning

confidence: 99%

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Study protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger

Kalsbeek

Roerdink

Krijnen

et al. 2020

BMC Musculoskelet Disord

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Background: The Dynamic Locking Blade Plate (DLBP) was recently introduced for fixation of displaced femoral neck fractures (FNF) and has been well received. Although the results of this implant in young patients are promising, the DLBP has not yet been compared to a standard device such as the Dynamic Hip Screw (DHS). The aim of this study is to compare the clinical outcome and costs of displaced FNF treated with internal fixation by means of either the DLBP or the DHS in patients up to 65 years of age. We hypothesize that the DLBP is superior compared to the DHS in terms of revision surgery rate, union rate, incidence of avascular necrosis and implant related failure. Methods: The DEFENDD (DisplacEd Femoral Neck fractures Dlbp versus Dhs) trial is a multicentre randomized controlled trial that will include 266 patients of 18-65 years with a displaced FNF. Patients will be randomized to receive either a DLBP or a DHS with a 1:1 allocation using a random block size, stratified for centre. Clinical follow up will last 1 year and questionnaires will be obtained up to 2 years. The main outcome parameter is the incidence of revision surgery within 1 year, due to either non-union, avascular necrosis (AVN) or cut out of the implant. Secondary study parameters are the incidence of avascular necrosis, non-union, (implant related) complications, functional outcome, elective removal of the implant and health-related quality of life and costs.Discussion: The outcome of the DEFENDD trial will provide high-level evidence of which implant is favourable for the treatment of femoral neck fractures in young patients (≤65 years).

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Section: Introductionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

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Study protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger

Kalsbeek

Roerdink

Krijnen

et al. 2020

BMC Musculoskelet Disord

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“…A recent paper describing the outcome of 320 patients treated with internal fixation reported an AVN rate of 4.5% for undisplaced and 11.1% for displaced intracapsular fractures with a minimum follow-up of two years [12]. This doubling of incidence further supports that osteosynthetic treatment should only be used in undisplaced femoral neck fractures [10,19,20].…”

Section: Discussionmentioning

confidence: 97%

A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients

Widhalm

Arnhold

Beiglböck

et al. 2019

JCM

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One of the most common fractures is that of the intracapsular femoral neck; however, the optimal implant for head-preserving treatment remains controversial. The aim of the study was to compare the outcomes of treating undisplaced intracapsular femoral neck fractures with either the dynamic hip screw (DHS) or the double cannulated screw fixation (CSFN). This retrospective cohort study analysed the data of 453 patients, with a mean age of 76.9 years, whose intracapsular fractures were treated with the DHS or CSFN between 2005 and 2013. The analysis focused on the rates of revision surgeries and complications; however, the impact of confounding exogenous factors, such as smoking and alcohol, were also considered. No significant difference was observed between the revision rates of DHS and CSFN (15.0% vs. 13.1%; p = 0.565). According to the complication rate, the advantage in favour of the CSFN was not significant (20.5% vs. 13.1%, p = 0.038). The use of the DHS was associated with a 13 min longer surgery (p < 0.0001) and a one day longer hospitalization (p = 0.242). Excessive consumption of alcohol was associated with an increased incidence of avascular necrosis (18.6% vs. 8.7%, p = 0.035). The choice of implant showed no significant impact on rates of revision surgery and complications. In terms of socioeconomic factors, the fixation with two cannulated screws was more favourable, making it the more cost-effective and less stressful method.

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“…Some studies have found that the stability of femoral neck fractures is of great signi cance to the revascularization of the femoral head, and plays an important role in promoting bone healing and reducing the rate of femoral head necrosis [14,15]. Moreover, It is reported that a large volume of implants may interfere with the revascularization of the femoral head and increase the incidence of femoral head necrosis [16]. The diameter of the screw bolt and the anti-rotation screw of FNS was 10 mm and 6.4 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures

Zhou

et al. 2020

Preprint

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Objective: To compare the early clinical effects of femoral neck system and three cannulated screws in the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis was conducted on 81 patients who received FNS or cannulated screws internal fixation for Pauwels Type-3 femoral neck fracture in our hospital from January 2019 to December 2019. A pair-matched clinical research was performed. People who received FNS were test group and people received cannulated screws were control group. Matching requirements were as follows： the same gender, the similar age and the similar BMI. A total of 30 pairs were successfully matched, with an average age of 53.84 years old. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative VAS score, time walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the two groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all the patients were followed up for 10-22 months. Patients in the FNS group had lower postoperative VAS scores, earlier time to walk without crutches, higher Harris scores at the last follow-up and lower complication rate (P<0.05). However, intraoperative blood loss and hospitalization costs in the FNS group were more（P<0.05）. There was no statistically significant difference in operation time, hospital stay and femoral head necrosis rate between two group (P>0.05).Conclusion: For patients who were unstable femoral neck fracture, FNS has better clinical efficacy than cannulated screws, though FNS is more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fracture.Fund program: Key medical research project of Jiangsu Health Committee（K2019010）

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Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures

Cited by 17 publications

References 18 publications

Study protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger

Study protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger

A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients

Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures

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