Biases in a randomized comparison of three types of screw fixation in displaced femoral neck fractures

Alho, A; Austdal, S; Jg, Benterud; Blikra, G; P, Lerud; Ts, Raugstad

doi:10.3109/17453679808997779

Cited by 21 publications

(8 citation statements)

References 15 publications

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“…In these cases, coxofemoral arthroplasty was performed. Like Alho et al 16 , 17 and Austdal et al (18) , we did not indicate osteosynthesis for elderly patients with displaced fractures. The very high reoperation rate and relatively long immobilization time make osteosynthesis a poor option.…”

Section: Discussionsupporting

confidence: 53%

“…In the biomechanical study conducted by Walker et al (15) , using only two screws was deemed sufficient. Alhol et al 16 , 17 and Austdal et al (18) also did not find any difference between using two and three screws, and observed a failure rate of around 14% both for two and for three screws, while in our study, the failure rate from using two screws was 13.3%. The failure rate that we found in cases of osteosynthesis of fractures in young patients was similar to what has been found by other authors, such as Henari et al (19) , whose sample of 12 patients presented failure in 25% of the cases.…”

Section: Discussionsupporting

confidence: 45%

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Osteosynthesis of Femoral Neck Fractures: Two or Three Screws?

Basile

Pepicelli

Takata

2012

Revista Brasileira de Ortopedia (English Edition)

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Objectives: To evaluate the efficacy of osteosynthesis on femoral neck fractures using two instead of three screws. Methods: Thirty-nine fractures were retrospectively evaluated, divided into groups in which two screws were used in parallel (n = 28) or three screws (n =11) in an inverted triangle configuration (in accordance with the AO technique). The patients were then followed up until reaching the outcome of either consolidation or failure. Results: In the group in which two screws were used, consolidation was observed in 23 of the 28 fractures (82%). In the group in which three screws were used, consolidation was observed in 6 of the 11 fractures (55%). There was no statistically significant difference between these percentages. Conclusion: There was no difference in the prognosis for these fractures when treated using two screws in parallel or three screws in an inverted triangle in accordance with the AO technique. Further studies are needed in order to establish a definitive conclusion.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionsupporting

confidence: 45%

Osteosynthesis of Femoral Neck Fractures: Two or Three Screws?

Basile

Pepicelli

Takata

2012

Revista Brasileira de Ortopedia (English Edition)

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show abstract

“…In the biomechanical study conducted by Walker et al (15) , using only two screws was deemed sufficient. Alhol et al (16,17) and Austdal et al (18) also did not find any difference between using two and three screws, and observed a failure rate of around 14% both for two and for three screws, while in our study, the failure rate from using two screws was 13.3%. The failure rate that we found in cases of osteosynthesis of fractures in young patients was similar to what has been found by other authors, such as Henari et al (19) , whose sample of 12 patients presented failure in 25% of the cases.…”

Section: Discussioncontrasting

confidence: 47%

“…In these cases, coxofemoral arthroplasty was performed. Like Alho et al (16,17) and Austdal et al (18) , we did not indicate osteosynthesis for elderly patients with displaced fractures. The very high reoperation rate and relatively long immobilization time make osteosynthesis a poor option.…”

Section: Discussionmentioning

confidence: 82%

Osteossíntese da fratura do colo femoral: dois ou três parafusos?

Basile¹,

Pepicelli²,

Takata³

2012

Rev. bras. ortop.

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“…Several studies have compared the use of different PTS configurations for the fixation of femoral neck fractures [ 3 , 17 – 20 ], but few have been published to compare the mechanical stability of the different screws configurations used in the unstable femoral neck fractures. Schaefer et al [ 21 ] demonstrated that replacing the posterior PTS with a FTS in femoral neck fracture with posterior comminution showed a potential benefit compared with the three PTS fixation models.…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis of different configurations of fully threaded cannulated screw in the treatment of unstable femoral neck fractures

Wang

et al. 2018

J Orthop Surg Res

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BackgroundIn the present study, we evaluated the mechanical outcome of different configurations formed by fully threaded screws and partially threaded screws in the treatment of unstable femoral neck fracture.MethodsThe Pauwels type III unstable femoral fracture and the models of the fully threaded screw and partially threaded screw were constructed in 3-matic software and UG-NX software respectively. We then assembled the different screw configurations to the fracture model separately to form the fixation models. After meshing the models’ elements, we used Abaqus software to perform the finite element analysis. Parameters of von Mises stress distribution on the screws, peak stress, displacement between fracture fragments, and model principal strains in cancellous bone were reported.ResultsOur results indicated that the peak von Mises stresses of screws was concentrated in the middle surface of the screw near the fracture line in each group. Peak stress value of the implants was highest in the model of triangle with posterior single screw. And the lowest stress values were observed in the triangular model. Fully threaded screw in each group underwent the most stress while partially threaded screw underwent a little bit of stress. Lowest displacement was observed in the triangular model. The volume of bone susceptible to yielding in the femoral neck region was the lowest for triangular configuration.ConclusionsFor unstable femoral neck fractures, superior results were obtained by stabilizing the fracture with triangular configuration formed by one superior partially threaded screw and two inferior fully threaded screws. This study will require clinical confirmation as to its practicality in the management of unstable femoral fractures.

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Biases in a randomized comparison of three types of screw fixation in displaced femoral neck fractures

Cited by 21 publications

References 15 publications

Osteosynthesis of Femoral Neck Fractures: Two or Three Screws?

Osteosynthesis of Femoral Neck Fractures: Two or Three Screws?

Osteossíntese da fratura do colo femoral: dois ou três parafusos?

Finite element analysis of different configurations of fully threaded cannulated screw in the treatment of unstable femoral neck fractures

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