Neck of femur fractures treated with the femoral neck system: outcomes of one hundred and two patients and literature review

Abstract

Introduction The recently developed femoral neck system (FNS) for treatment of femoral neck fractures (FNF), comprises theoretical biomechanical advantages compared to other implants. The aim of this study was to validate the safety and to report outcomes of patients treated with the FNS. Method A retrospective multicentric analysis of patients treated by FNS with a minimum of three months of follow-up. Details analysed from three medical centres were operative duration, estimated blood loss, initial hospitalisation duration, fixation quality as well as complications and reoperation rate. Patients who had revision surgery were compared to all other patients to identify risk factors for failure. In addition, a literature review was performed to analyse data on FNS clinical implementation and patient’s outcomes. The two data sets were combined and analysed. Results One-hundred and two patients were included in this study cohort with an average follow-up of seven months (range 3–27). Ten papers were included in the literature review, reporting data on 278 patients. Overall, 380 patients were analysed. Average age was 62.6 years, 52% of the fractures were classified as Gardens 1–2. Overall, the revision rate was 9.2% (14 patients diagnosed with cut-out of implant, 10 with AVN, 8 with non-union and 8 with hardware removal). For the 102 patients in the cohort risk factors for reoperation included patients age, surgeon seniority and inadequate placement of the implant. Conclusion This study shows that FNS is a safe treatment option for FNF. Intra-operative parameters and failure rates are comparable to previously reported rates for this implant and other frequently used implants.

Fixation of Femoral Neck Fracture with Femoral Neck System : A retrospective cohort study of 43 patients

“…The overall failure rate of FNS in our study, with a mean follow-up of 11.8 months, was 9.3% (4/43 patients), and the results were similar or superior to those reported in previous studies (8.8-21%) 3,14,15 . Even in patients with Pauwels type 3 fracture, which is a relative contraindication to MCS xation, complete bone union was achieved without major complications such as nonunion or angular deformation in most patients (Table 1).…”

Efficacy and risk factor analysis of femoral neck system for femoral neck fractures：a retrospective study

“…These factors may contribute to complications. The longer the length of operation and length of incision the more volume of blood loss, and for FNF of Garden III, IV, and Pauwels III, an experienced operator is necessary [12].…”

“…The results showed a complication rate of 10.09% and a reoperation rate of 6.4% for FNF treated by FNS. Another study[12] analyzed combined patients from clinical and literature records with a mean age of 62.6 years, which revealed a complication rate of 10.52% and a reoperation rate of 9.2% after surgery for femoral neck fractures treated by FNS, and the…”

Evaluation of a Locking Autocompression Screw Model in Pauwels Type-3 Femoral Neck Fracture: In Vitro Analysis

“…Unfortunately, their conclusion cannot be extrapolated to the more vertical P3 FNF. Davidson et al [ 29 ] conducted a multicenter retrospective cohort analysis of patients treated with a femoral neck system, including 102 patients with a mean follow-up of 7 months. The fractures were classified according to the Garden system rather than Pauwels system.…”