Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly

Panteli, Michalis; Rodham, Paul; Giannoudis, Peter V.

doi:10.1016/j.injury.2014.12.031

Cited by 128 publications

(99 citation statements)

References 70 publications

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“…They found nonunion in 12% of the patients treated with 16 mm threaded screw whereas in the present study we observed nonunion in 9% of the patients treated with 16 mm threaded screw. In addition, the nonunion rate was 18% in the full threaded screw group in this study which was consistent with the results of Parker's study [31]. Parker et al observed nonunion in the 15% of the patients treated with 32 mm threaded screw [31].…”

Section: Discussionsupporting

confidence: 91%

“…In addition, the nonunion rate was 18% in the full threaded screw group in this study which was consistent with the results of Parker's study [31]. Parker et al observed nonunion in the 15% of the patients treated with 32 mm threaded screw [31]. Moreover, functional outcomes for both full threaded and 16 mm threaded screw group in the current study was similar with the functional outcomes for 32 mm and 16 mm threaded screw group in Parker's study.…”

Section: Discussionsupporting

confidence: 91%

“…The nonunion rate in our study was comparable with that of Parker's study [31]. They found nonunion in 12% of the patients treated with 16 mm threaded screw whereas in the present study we observed nonunion in 9% of the patients treated with 16 mm threaded screw.…”

Section: Discussionsupporting

confidence: 89%

“…Parker et al demonstrated that there were no statistical differences between the short (16 mm) and long (32 mm) threaded screws for any of the outcomes including nonunion, fracture below the implant, avascular necrosis, implant removal, reoperation rates and functional status [31]. In the current study, full threaded, cannulated compression screws were compared with 16 mm partial threaded cannulated compression screws in the treatment of femoral neck fractures.…”

Section: Discussionmentioning

confidence: 63%

“…Compression screws (CS) and fixed-angle dynamic implants, or a combination of both, promote union during weight bearing by allowing the fracture fragments to slide along the implant while being axially loaded [20]. The use of the multiple compressive screws has been advocated for Garden types 1 and 2 in attaining union [30,31]. A review of randomized trials that have compared the different implants reported that multiple screws supply better stabilization of fixation than pins [32].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Should full threaded compression screws be used in adult femoral neck fractures?

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Özkayın

Erkan

et al. 2015

Injury

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Should full threaded compression screws be used in adult femoral neck fractures?

Okçu

Özkayın

Erkan

et al. 2015

Injury

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Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Finnilä

Moritz

Strandberg

et al. 2018

Journal Orthopaedic Research

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We examined the feasibility of radiostereometric analysis (RSA) in the assessment of the initial stability of internally fixed femoral neck fractures. The study included 16 patients (mean age 73 years). During surgery, multiple RSA‐beads were inserted on both sides of the fracture. Radiographs for RSA were taken in the supine position within the first 3 days and 6, 12, 24, and 52 weeks after surgery. To detect any inducible motion at the fracture‐site, radiographs for RSA were taken with the patient resting or applying a load through the fracture. Fracture loading was achieved by the patient pressing the ipsilateral foot as much as tolerated on a force plate while providing a counterforce through both hands. Micromotion exceeding the precision values of RSA (≥0.3 mm for the translation vector and/or ≥1.2 degrees for the rotation vector) was considered significant. Permanent three‐dimensional fracture‐site displacement was also recorded. Voluntary loading induced fracture‐site micromotion, which exhibited a dichotomous distribution. In patients with uncomplicated fracture union, inducible micromotion was detectable only at baseline—if at all. Conversely, fractures that developed a nonunion were characterized by the continuation of inducible micromotion beyond baseline. Permanent fracture‐site displacement was, on average, nearly an order of magnitude greater than the inducible micromotion. Fracture unions were characterized by the cessation of permanent fracture‐site displacement by 12 weeks. Nonunions presented as outliers in permanent fracture‐site displacement. Large‐scale studies are warranted to evaluate whether the detection of inducible micromotion beyond baseline could serve as an indicator of insufficient fixation stability. © 2018 The Authors. Journal of Orthopaedic Research ® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society.

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Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

Ying

Wang

Ding

et al. 2019

Journal Orthopaedic Research

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A combination treatment with porous tantalum rod implantation and intra-arterial infusion of peripheral blood stem cells (PBSCs) provides a promise for treating early and intermediate stages of osteonecrosis of the femoral head (ONFH). However, its clinical indications and application restrictions remain unclear. This study aims to determine the clinical, histological, and radiological outcomes of a combination treatment using mechanical support and a targeted intra-arterial infusion of PBSCs for painful ONFH with a capshaped separation (CSS) cartilage defect. Compared with the standard pain management (control group), this combination treatment did not improve the Harris Hip Score (HHS) at 36 months. Micro-CT and histologic analyses showed severe focal destruction in all CSS-ONFH femoral heads in both the combination and control groups. Femoral heads showed a higher percentage of bone lesions in the combination treatment group than in the control group. There was no significant difference in osteoclast number in the subchondral bone areas between the two groups. A high level of expression of inflammatory cytokines, including tumor necrosis factor-α and interleukin-1β, was detected in blood vessels around the subchondral bone in both groups. The RANKL/OPG (receptor activator of the nuclear factor-kB ligand/osteoprotegerin) ratio was also similar between the control and combination treatment groups. Our results indicate that this combination treatment is not an effective method for the treatment of patients with painful CSS-ONFH. Moreover, this combination treatment did not inhibit inflammatory osteoclastogenesis in patients with more advanced disease.

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Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly

Cited by 128 publications

References 70 publications

Should full threaded compression screws be used in adult femoral neck fractures?

Should full threaded compression screws be used in adult femoral neck fractures?

Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading

Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

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