Displaced Femoral Neck Fractures in Young Healthy Patients: The Technique

Gorczyca, John T.

doi:10.1007/978-3-030-84444-8_3

Cited by 1 publication

(2 citation statements)

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“…While some orthopedic specialists have recommended that the screw tip should be located within 5 mm of the subchondral bone, 15 others have suggested a distance of 5-10 mm. 16 However, reliability data for these recommendations are lacking.…”

Section: Introductionmentioning

confidence: 99%

“…Since the articular surface of the femoral head approximates a hemisphere, the apex–subchondral bone distance on the AP and lateral views is related to the location of the screw in the femoral head. While some orthopedic specialists have recommended that the screw tip should be located within 5 mm of the subchondral bone, 15 others have suggested a distance of 5–10 mm 16 . However, reliability data for these recommendations are lacking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Optimal position and apex–subchondral bone distance of cannulated screws for internal fixation of femoral neck fracture: A radiological study

Zhu

Liao

2022

Journal Orthopaedic Research

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To determine the optimal position of three cannulated screws in an inverted triangle pattern for internal fixation of femoral neck fractures, including the apex-subchondral bone distance, computed tomography (CT) images of the hip were processed using the MIMICS (Materialize Interactive Medical Image Control System) Research software. Points adjacent to the inferior, anterosuperior, and posterior cortex of the femoral neck were selected on the axial view.Subsequently, the positions of these points were adjusted to maximize the area between them, and splines were drawn in the coronal and sagittal planes to represent the cannulated screws. Finally, the virtual anteroposterior and lateral fluoroscopy images of the proximal femur and splines were created and the parameters calculated. Finite element analysis showed this fixation scheme provides stronger fracture support and stability. Twenty patients with femoral neck fractures (Modified group), with the area and perimeter of the triangle formed on axial postoperative CT images, including the shortest distance from the tip of the screw to the subchondral bone was compared with 23 matched patients for whom the conventional inverted isosceles triangle configuration of screws for internal fixation was used (Conventional group). The area and perimeter of the stabilization screws were larger, with a shorter apex-subchondral bone distance for the Modified group. There was no incidence of screw penetration in the femoral neck or head in either group, and all fractures healed within a follow-up period of 10 months. The modified screw placement method is simple and safe and provides greater fracture stability than the conventional empirical method of fixation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%