Comparison of time to healing and major complications after surgical fixation of nondisplaced femoral neck stress fractures: A systematic review

Kolaczko, Jensen G.; McMellen, Christopher J; Magister, Steven; Wetzel, Robert J.

doi:10.1016/j.injury.2021.02.046

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…14 Internal fixation with cannulated screws or a sliding hip screw (SHS) is the most popular contemporary surgical treatment option for injuries that do not respond to conservative measures. 15 Subsequently, the use of internal fixation with cannulated screws, which was used in this case and was quite effective, was in line with what earlier research had shown.…”

Section: Discussionsupporting

confidence: 87%

A Case of a Young Military Officer with Bilateral Simultaneous Femoral Neck Stress Fracture

Khired

2024

IMCRJ

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Stress fractures of the femoral neck are rare in young adults and usually happen when the bone is repeatedly put under a lot of stress or because of a bone disease. The incidence of stress fractures is a major health concern for soldiers. Most often, stress fractures affect the metatarsals and tibias, while injuries to the femoral neck are less common. Exertional groin or anterior thigh discomfort that develops gradually over time is often vague and subtle; therefore, a high index of clinical suspicion is indicated. In most cases, the first radiographs will be normal. In order to properly diagnose a stress fracture in the femur, a CT scan is very helpful. Because most femoral neck fractures are not displaced when patients present with them, a diagnosis is often delayed. In conclusion, new military soldiers feeling hip pain should have a thorough medical evaluation to establish an early diagnosis and prevent any consequences.

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Section: Discussionsupporting

confidence: 87%

A Case of a Young Military Officer with Bilateral Simultaneous Femoral Neck Stress Fracture

Khired

2024

IMCRJ

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“…To date, only a few studies have investigated sFNFs and they have mainly focused on the younger, more active population (e.g., recreational runners and military recruits) ( 12 , 18 , 19 ). Our findings, based on data from the SFR, indicate a biphasic distribution of fractures with a younger active population and an older population with possibly lower quality of bone or impaired bone repair mechanisms ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

Stress fractures of the femoral neck in adults: an observational study on epidemiology, treatment, and reoperations from the Swedish Fracture Register

Sundkvist

Möller

Rogmark

et al. 2022

ActaO

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Background and purpose: Stress fractures of the femoral neck (sFNFs) are uncommon injuries. Studies on sFNFs are rare. We describe the demographics, classification, treatment, reoperation rates, and mortality in a cohort of sFNF patients from the Swedish Fracture Register (SFR). Patients and methods: We included 146 patients ≥ 18 years of age with an sFNF registered in the SFR between 2011 and 2020. The cohort was linked with the Swedish Arthroplasty Register and reviewed using medical records and radiographs. We assessed the presence of disorders of bone remodeling, duration of symptoms, fracture classification, treatment, reoperations, and mortality. Results: The mean age was 58 years (21–96), 75% were women and the median duration of symptoms was 23 days (1–266). 40% of patients had disorders of bone remodeling. 54% were undisplaced (uFNF), 30% displaced (dFNF), and 16% basicervical (bFNF). 14% of patients < 60 years were treated nonoperatively, by internal fixation (IF) in 77% and by arthroplasty in 10%. Patients ≥ 60 years weretreated nonoperatively in 10%, IF in 40%, and arthroplasty in 49%. Nonoperative treatment was reserved for uFNFs or bFNFs, resulting in 35% receiving late surgery. The overall secondary or late surgery rate was 19%. Mortality was 2% at 90 days and increased to 3% at 1 year. Interpretation: sFNF has a biphasic age distribution. One-third of patients presented with a displaced FNF and those managed nonoperatively for an undisplaced sFNF were at risk of late surgery. The mortality rates for patients with these injuries was low.

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“…Delay to weightbearing beyond 12 weeks was also found as a risk fractor for reoperation. In fact, recent studies recommend an early transition to full weight bearing [8,44]. A study by Kolaczko et al showed that limiting weight bearing for more than 8 weeks may negatively affect bone healing [44].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, recent studies recommend an early transition to full weight bearing [8,44]. A study by Kolaczko et al showed that limiting weight bearing for more than 8 weeks may negatively affect bone healing [44]. In turn, this could lead to prolonged higher loads on the implant and thus promote implant failure.…”

Section: Discussionmentioning

confidence: 99%

High Percentage of Complications and Re-Operations Following Dynamic Locking Plate Fixation with the Targon® FN for Intracapsular Proximal Femoral Fractures: An Analysis of Risk Factors

Gütler

Delagrammaticas

et al. 2022

Medicina

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The ideal surgical treatment of femoral neck fractures remains controversial. When treating these fractures with internal fixation, many fixation constructs exist. The primary aim of this study was to evaluate the incidence and specific risk factors associated with complication and re-operation following fixation of intracapsular proximal femoral fractures using the Targon-FN system (B.Braun Melsungen AG). A secondary aim was to identify if lateral prominence of the implant relative to the lateral border of the vastus ridge was a specific risk factor for elective plate removal. Methodically, a retrospective case series was conducted of all consecutive adult patients treated at a single level 1 trauma center in Switzerland for an intracapsular proximal femoral fracture with the Targon-FN. Demographic data were collected. Patients with a follow-up of less than three months were excluded. Complications as well as plate position were recorded. Statistical analysis to identify specific risk factors for re-operation and complications was performed. In result, a total of 72 cases with intracapsular femoral neck fractures were treated with the Targon-FN locking plate system between 2010 and 2017. Thirty-four patients (47.2%) experienced one or more complications. The most common complication was mechanical irritation of the iliotibial band (ITB) (23.6%, n = 17). Complications included intraarticular screw perforation (6.9%, n = 5), avascular necrosis (5.6%, n = 4), non-union (5.6%, n = 4) among others. In total, 46 re-operations were required. Younger age, fracture displacement and time to postoperative weight bearing were identified as risk factors for re-operation. In conclusion, intracapsular femoral neck fractures treated with the Targon-FN system resulted in a high rate of post-operative complication and re-operation. Statistical analysis revealed patient age, fracture displacement, time to postoperative full weight bearing were risk factors for re-operation. The main limitation is the limited number of cases and a short follow-up of less than 12 months in a subgroup of our patients.

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Comparison of time to healing and major complications after surgical fixation of nondisplaced femoral neck stress fractures: A systematic review

Cited by 4 publications

References 13 publications

A Case of a Young Military Officer with Bilateral Simultaneous Femoral Neck Stress Fracture

A Case of a Young Military Officer with Bilateral Simultaneous Femoral Neck Stress Fracture

Stress fractures of the femoral neck in adults: an observational study on epidemiology, treatment, and reoperations from the Swedish Fracture Register

High Percentage of Complications and Re-Operations Following Dynamic Locking Plate Fixation with the Targon® FN for Intracapsular Proximal Femoral Fractures: An Analysis of Risk Factors

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