Undisplaced femoral neck fractures need a closed reduction before internal fixation

Yamamoto, Tatsuya; Kobayashi, Yoshiomi; Nonomiya, Hiroaki

doi:10.1007/s00590-018-2281-0

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…In contrast, other complication rates were almost equivalent to those reported previously [4,6,7,8,9]. Four cases of mortality were due to deteriorating pre-existing disease.…”

Section: Discussionsupporting

confidence: 76%

“…Previously reported studies showed that complication rates one year after osteosynthesis for femoral neck fracture in elderly patients were as follows: mortality (12.7%) [4], SSI (1%) [5], loss of reduction (4.3%) [5], aseptic necrosis (4-39%) [6,7], LSC (12.5%) [8], nonunion (8.9%) [9], periprosthetic fracture (1-2%) [5]. In our study, the incidence of loss of reduction rate and periprosthetic fracture rate were relatively high.…”

Section: Discussionmentioning

confidence: 99%

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Complications of femoral neck fracture fixation using a sliding hip screw with a side plate device in patients older than 65 years

Mitsugi

Miyamoto

Izumi

et al. 2020

Preprint

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BackgroundA majority of femoral neck fractures are indicated for surgical treatment within the scope of applicable guidelines. However, the reported overall complication rate in elderly patients one year after hip fracture fixation was 33.3%. The purpose of this study was to clarify the incidence of complications one year after femoral neck fracture fixation using a sliding hip screw with a side plate device in elder than 65-year-old patients.MethodsWe studied the results of 115 cases of the internal fixation for femoral neck fractures in patients older than 65 years of age using the Twins device (HOYA Technosurgical Corporation, Tokyo, Japan). We could follow up 39 of these 115 cases at one year after fixation and retrospectively investigated complications in these patients. Research outcomes were mortality, surgical site infection (SSI), loss of reduction, aseptic necrosis, late segmental collapse (LSC), nonunion, periprosthetic fracture, reoperation, and recovery of walking ability.ResultsThe patients consisted of 13 men and 26 women (mean age 80.5 years, range 65-104 years). Mortality was observed in four cases (14.2%), SSI in one case (2.5%), loss of reduction in six cases (15.4%), aseptic necrosis in seven cases (17.9%), LSC in three cases (7.6%), nonunion in eight cases (20.5%), periprosthetic fracture in three cases (7.6%), and reoperation was performed in seven cases (17.9%), respectively. In 28 cases, the patients could walk independently before injury; this decreased to 19 cases after injury (67.9%).ConclusionsIn our study, the incidence of loss of reduction rate and periprosthetic fracture rate were relatively high. Other complications of the Twins device evaluated were equivalent to those reported previously.

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“…In contrast, other complication rates were almost equivalent to those reported previously [4,6,7,8,9]. Four cases of mortality were due to deteriorating pre-existing disease.…”

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Complications of femoral neck fracture fixation using a sliding hip screw with a side plate device in patients older than 65 years

Mitsugi

Miyamoto

Izumi

et al. 2020

Preprint

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“…We have found only 1 clinical Pinloc study: a retrospective study on 40 patients with no control group (Yamamoto et al. 2019).…”

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confidence: 98%

Similar outcome of femoral neck fractures treated with Pinloc or Hansson Pins: 1-year data from a multicenter randomized clinical study on 439 patients

et al. 2019

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Background and purpose — There are few reports on the efficiency of the Hansson Pinloc System (Pinloc) for fixation of femoral neck fractures. We compare Pinloc with the commonly used Hansson Pin System in a randomized clinical trial. The primary outcome measure is non-union or avascular necrosis within 2 years. We now report fracture failures and reoperations within the first year.Patients and methods — Between May 2014 and February 2017, 439 patients were included in the study. They were above 50 years of age and treated for a femoral neck fracture at 9 orthopedic departments in Sweden. They were randomized to either Pinloc or Hansson pins. The fractures were grouped as (a) non-displaced regardless of age, (b) displaced in patients < 70 years, or (c) ≥ 70 years old, but deemed unfit to undergo arthroplasty. Follow-up with radiographs and outpatient visits were at 3 and 12 months. Failure was defined as early displacement/non-union, symptomatic segmental collapse, or deep infection.Results — 1-year mortality was 11%. Of the 325 undisplaced fractures, 12% (21/169) Pinloc and 13% (20/156) Hansson pin patients had a failure during the first year. The reoperation frequencies were 10% (16/169) and 8% (13/156) respectively. For the 75 patients 50–69 years old with displaced fractures, 11/39 failures occurred in the Pinloc group and 11/36 in the Hansson group, and 8/39 versus 9/36 patients were reoperated. Among those 39 patients ≥ 70 years old, 7/21 failures occurred in the Pinloc group and 4/18 in the Hansson group. Reoperation frequencies were 4/21 for Pinloc and 3/18 for the Hansson pin patients. No statistically significant differences were found in any of the outcomes between the Pinloc and Hansson groups.Interpretation — We found no advantages with Pinloc regarding failure or reoperation frequencies in this 1-year follow-up.

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“…For the more unstable fractures, the F-shape nails technology has better stability than the traditional technology. A retrospective study by Yamamoto et al found that a posterior angle of more than 15° is a risk factor for AVN after internal xation of femoral neck fractures [14], while a biomechanical study by Filipov et al showed that the F-shape nails technique may be superior to traditional parallelism in controlling posterior inclination [12]. A retrospective study of 43 patients by Wang et al showed that the Fshape nails technique can achieve better curative effect in the treatment of Pauwels femoral neck fracture, and the incidence of postoperative complications is lower [15].…”

Section: Disscusionmentioning

confidence: 99%

Comparison of the Effects of Two Different Hollow Nails in the Treatment of the Young Pauwels Type Ⅲ Femoral Neck Fractures

Cheng

Ding

2021

Preprint

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Background: At present, there is a higher complication rate after treatment of femoral neck fractures with three parallel hollow nails (PHN) in the young Pauwels type Ⅲ femoral neck fractures.For better effect,F-shape hollow nails(FHN) is used to treat femoral neck fractures.The purpose of this study is to compare the clinical efficacy of FHN and PHN and provide reference for clinical application.Methods: Thirty-eight consecutive patients admitted from January 2017 to January 2020 were selected for the study. According to random number table method, the patients were divided into two groups:group A (FHN) and group B (PHN). The gender, age, BMI, comorbidities, time from injury to operation and other general preoperative demographics were not statistically different (P>0.05). The data of the two groups can be comparable.The occurrence of avascular osteonecrosis of the femoral head (AVN), femoral neck shortening, hollow screw withdrawal was recorded in follow-up.Then, Harris hip score (HHS), pain visual analog score (VAS) of two group were obtained at the last follow-up. Results: The mean follow-up period after surgery was 21.4±10.1 (range, 14–29) months. There were 18 cases(mean age, 47.5±9.6) in group A, 20 cases (mean age, 48.6±10.1) in group B. There was no significant difference between the two groups in AVN, femoral neck shortening (P>0.05), the two groups had statistically significant differences in screw withdrawal (F=4.416, P<0.05). There was no significant difference in HHS and VAS between the two groups at the last follow-up (P>0.05).Conclusion: Three parallel hollow nails (PHN) and F-shape hollow nails (FHN) have similar short-term effects in the young Pauwels type Ⅲ femoral neck fractures, but the nail withdrawal rate of FNH is lower.

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Undisplaced femoral neck fractures need a closed reduction before internal fixation

Abstract: The fixation timing < 48 h decrease the risk of fracture healing complications and sufficient reduction may reduce the risk of secondary operation. Preoperative posterior tilt ≥ 20° and complete fractures on CT scans were related to poor prognosis.

Cited by 21 publications

References 21 publications

Complications of femoral neck fracture fixation using a sliding hip screw with a side plate device in patients older than 65 years

Complications of femoral neck fracture fixation using a sliding hip screw with a side plate device in patients older than 65 years

Similar outcome of femoral neck fractures treated with Pinloc or Hansson Pins: 1-year data from a multicenter randomized clinical study on 439 patients

Comparison of the Effects of Two Different Hollow Nails in the Treatment of the Young Pauwels Type Ⅲ Femoral Neck Fractures

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