Review on Basicervical Femoral Neck Fracture: Definition, Treatments, and Failures

Abstract

Basicervical femoral neck fracture is an uncommon fracture that accounts for only 1.8% of all proximal femoral fractures. Previous studies have recommended that the choice of implant to treat this fracture should be similar to that of intertrochanteric fracture. However, in previous studies on basicervical fractures, the definition and treatment results of these fractures were different, and there were also debates on the implant that had to be used. Therefore, the purpose of this study was to review the studies that performed surgical treatment of basicervical femoral fractures and to assess the definition of basicervical fracture, the use of implants, and failure rates and clinical results. Study selection was based on the following inclusion criteria: (1) treatment outcome for basicervical femoral neck fracture was reported; and (2) dynamic hip screw, proximal femoral nail, or multiple screw fixation was used as treatment. PubMed Central, OVID MEDLINE, Cochrane Collaboration Library, Web of Science, EMBASE, and AHRQ databases were searched to identify relevant studies published up to March, 2020 with English language restriction. A total of 15 studies were included in this study. Differences were found in the definition of basicervical fracture, treatment results, rehabilitation protocol, and fixation failure rate. Definitions and treatment methods for basicervical fractures varied, and treatment outcomes also differed among the enrolled studies. Further research is needed that would be restricted to those fractures that conform to the definition of basicervical fracture.

Management of proximal femur fractures in the elderly: current concepts and treatment options

“…Accounting for only 1.8% of all PFFs, basicervical femoral neck fractures are quite uncommon [ 67 ]. The treatment options include both a cephalomedullary nail, a dynamic hip screw and cancellous screws.…”

“…The treatment options include both a cephalomedullary nail, a dynamic hip screw and cancellous screws. When the latter were used, a higher failure rate was observed [ 67 ]. Reviewing treatments and failures of basicervical femoral neck fractures, Yoo et al stated that further research with a homogenous definition on treatment results or fixation failure are needed to perform a meta-analysis for clear recommendations [ 67 ].…”

“…When the latter were used, a higher failure rate was observed [ 67 ]. Reviewing treatments and failures of basicervical femoral neck fractures, Yoo et al stated that further research with a homogenous definition on treatment results or fixation failure are needed to perform a meta-analysis for clear recommendations [ 67 ]. The surgical treatment should focus on the biological and not on the chronological age (Figs.…”

Reverse wedge effect following intramedullary nail fixation of trochanteric fracture, what does it imply?

“…In addition,the terminology of basicervical trochanteric fracture is mentioned in this paper. Debates still hold relating to the unified nomination of it [ 20 , 21 ]. However, the definition has been clearly explained as proximal femur fractures through the base of the femoral neck at its junction with the intertrochanteric region [ 22 ].…”

Epidemiology, classification, treatment, and mortality of adult femoral neck and basicervical fractures: an observational study of 40,049 fractures from the Swedish Fracture Register

“…FNFs are mainly classified into undisplaced or minimally displaced (Garden 1–2, uFNF) and displaced fractures (Garden 3–4, dFNF). A third, less studied category of fractures is the basicervical FNFs (bFNFs), defined as fractures through the base of the femoral neck at their junction with the intertrochanteric region [ 2 ].…”