Early loss of fixation of femoral neck fractures Comparison of three devices in 244 cases

Abstract

In successive series of displaced subcapital femoral neck fractures in the elderly, we operated on 75 cases with three Gouffon screws, 94 with three Mecron screws, and 75 with two von Bahr screws. Redisplacement within 3 months occurred in 20 Gouffon cases, 11 Mecron cases, and 12 von Bahr cases. Poor reduction contributed to the failures in all the groups. Although the reduction results in the three groups were similar, the Mecron group had better fixation and better social recovery than the Gouffon group. We concluded that, in addition to good reduction of the fracture, solid screws also contributed to the stability of the bone-implant construct.

Internal fixation of femoral neck fractures

“…No previous studies comparing the two methods of osteosynthesis of the femoral neck fracture described in the present investigation, have been published, but quite a number of studies deal with the treatment of this "unsolved fracture" (Frandsen 1986, Linde et al 1986, Elmerson et al 1988, Husby et al 1989, Holmberg et al 1990). The conclusions of the various studies are not unanimous.…”

“…Among the patients treated with Gouffon screws, 25/38 developed complications. This complication rate was unusually high for multiple pinning (Kofoed and Alberts 1980, Hoeg et al 1982, Stromqvist et al 1984, Madsen et al 1987, Husby et al 1989, Lindequist et al 1989, Rehnberg and Olerud 1989a. Poor reduction (1 1/38) (Kofoed and Alberts 1980, Hoeg et al 1982, Frandsen 1986, and, to a lesser degree, poor positioning of the screws (6/38) (Frandsen 1986, Skinner and Powles 1986, Rehnberg and Olerud 1989a could be important factors.…”

Radiographic prediction of early failure in femoral neck fracture

“…At that time. primary mechanical failures occur (Husby et al 1989). and they constitute one half of all the failures (Nieminen et al 1974, Barnes et al 1976.…”

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

“…Fixation with multiple screws is currently a common treatment for displaced femoral neck fractures (Brown and Court-Brown 1976, Madsen et al 1987, Husby et al 1989, Sernbo et al 1990). Although the differences between different screw designs may not be essential, the interest in comparing implants has focused on an important orthopedic problem, which is the fracture itself.…”