Spontaneous non-traumatic dislocation of the hip as a complication of screw-plate fixation of a femoral neck fracture

Combalia, M; Muñoz-Mahamud, Ernesto; Febles-Oviedo, J L; Fernández-Valencia, Jenaro Á.; Combalía, A.

doi:10.1016/j.injury.2021.02.063

Cited by 3 publications

(10 citation statements)

References 14 publications

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“…It remains a challenge for the treatment of femoral neck fractures in young adults, especially Pauwels type III subcapital fractures [8]. The principle of treatment for such injuries is early anatomical reduction and internal fixation with adequate preservation of the blood supply to the femoral head [9].…”

Section: Introductionmentioning

confidence: 99%

Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality

Zhao

Liu

et al. 2021

J Orthop Surg Res

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Objective Femoral neck fracture is one of the most common bone types. The effect of reduction quality on hip joint function and complications after screw internal fixation is not fully understood. To investigate the clinical efficacy and mechanical mechanism of positive buttress, anatomical reduction, and negative buttress in the treatment of femoral neck fracture after cannulated screw fixation. Methods Retrospective analysis of patients with femoral neck fracture treated with three cannulated screws internal fixation in our hospital from January 2013 to December 2018. According to the quality of fracture reduction, the patients were divided into positive buttress group, anatomical reduction group, and negative buttress group. Basic information such as injury mechanism, time from injury to surgery, Garden classification and Pauwels classification was collected, Harris scores were performed at 3 months, 6 months, and 12 months after surgery, and postoperative complications (femoral head necrosis, femoral neck shortening, and femoral neck nonunion) were collected. At the same time, three groups of finite element models with different reduction quality were established for stress analysis, their stress clouds were observed and the average displacement and stress of the three groups of models were compared. P < 0.05 was used to represent a statistically significant difference. Results A total of 225 cases of unilateral femoral neck fractures were included and followed up for an average of 4.12 ± 0.69 years. There was no significant difference in age, gender, side, injury mechanism, time from injury to surgery, BMI, Garden classification, Pauwels classification, and follow-up time among the three groups (P > 0.05). However, there was significant difference in Harris score at 6 and 12 months after operation among the three groups (P < 0.05), which was higher in the positive buttress group and anatomical reduction group than in the negative buttress group. In addition, the incidence of osteonecrosis of the femoral head in the negative buttress group (32.2%) was greater than that in the anatomical reduction group (13.4%) and the positive buttress group (5.4%) (P < 0.05). In addition, the incidence of femoral neck nonunion and femoral neck shortening in the negative buttress group was also higher than that in the anatomical reduction positive buttress group (P < 0.05). The finite element results showed that the stress and fracture end displacement in the negative buttress group were greater than those in the positive buttress group (P < 0.05). Conclusion Both positive buttress and anatomical reduction in the treatment of femoral neck fracture with cannulated screw internal fixation can obtain better clinical effect and lower postoperative complications. Positive brace support and anatomic reduction can limit the restoration of femoral stress conduction. Therefore, it is not necessary to pursue anatomical reduction too deliberately during surgery, while negative buttress reduction should be avoided.

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Section: Introductionmentioning

confidence: 99%

Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality

Zhao

Liu

et al. 2021

J Orthop Surg Res

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“…12 Once a septic subluxation has occurred with associated changes in the femoral head and acetabulum, the only viable treatment option is debridement and resection arthroplasty followed by a replacement procedure later. [1][2][3]6 The authors believe that subluxation without hip pain after surgery should be viewed with concern and should raise the suspicion of a deep-seated infection. Subtle hip subluxation and increased medial joint space are often missed on radiographs and only detected retrospectively; however, these can be very early and reliable radiographic signs pointing to a deep septic process in a postoperative hip joint.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,10 The outcome in both septic and aseptic dislocations is mostly poor, and often replacement surgery is needed. 6 This report presents two patients with hip subluxation after minimally invasive fixation of displaced transcervical femoral neck fractures with CCS. Ethical approval was granted for the study by the Maulana Azad Medical College Ethical Clearance Board (MAM/LNH/120/2).…”

mentioning

confidence: 98%

“…[1][2][3][4] A subluxation or dislocation after internal fixation of femoral neck fractures is even more uncommon, and almost all reported cases involve basicervical fractures fixed with a screw-plate combination. [5][6][7][8] To the best of the authors' knowledge, hip subluxation or dislocation after fixation of a transcervical femoral neck fracture with a minimally invasive implant like a cannulated cancellous screw (CCS) has not been reported in the literature to date. 9 Dislocation or subluxation after fixation can occur with (septic) or without (aseptic) infection.…”

mentioning

confidence: 99%

“…In the absence of infection, excessive valgus fixation, neck collapse, and capsular injury are the described mechanisms while septic subluxation or dislocation usually involves tense intraarticular collection or destruction of restraining structures caused by hip joint sepsis. 6 The deep sepsis in such cases is usually a low-grade infection caused by Staphylococcus aureus or epidermidis presenting without any systemic signs. 1,2,10 The outcome in both septic and aseptic dislocations is mostly poor, and often replacement surgery is needed.…”

mentioning

confidence: 99%

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Subtle hip joint subluxation after femoral neck fracture fixation: an ominous sign in a report of two cases

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Femoral neck system and cannulated compression screws in the treatment of non-anatomical reduction Pauwels type-III femoral neck fractures: A finite element analysis

Zhong

Lan

Xiang

et al. 2023

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Spontaneous non-traumatic dislocation of the hip as a complication of screw-plate fixation of a femoral neck fracture

Cited by 3 publications

References 14 publications

Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality

Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality

Subtle hip joint subluxation after femoral neck fracture fixation: an ominous sign in a report of two cases

Femoral neck system and cannulated compression screws in the treatment of non-anatomical reduction Pauwels type-III femoral neck fractures: A finite element analysis

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