Factors influencing femoral neck fracture healing after internal fixation with dynamic locking plate

Morochovič, Radoslav; Takáčová, Katarína; Tomcovcík, L; Cibur, Peter; Burda, Rastislav

doi:10.1007/s00402-018-03103-5

Cited by 10 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have shown that the failure rate of the treatment of fractures with head preservation and femoral neck is higher, some of which exceed 40% [ 10 ]. Some FNFs cannot be accurately reduced and fixed due to two reasons [ 11 ]: on the one hand, the surgeon is not experienced enough to fully grasp the reduction skills, and the intraoperative C-arm X-ray fluoroscopy is not enough to show the direction and degree of fracture displacement in detail. On the one hand, the fracture displacement is serious, and it is difficult to perform anatomical reduction using conventional reduction techniques.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study between Proximal Femoral Locking Plate and Multiple Cannulated Screws for Fixation of Femoral Neck Fractures in Young Adults

Zhang

Zhuang

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

Objective. To compare the clinical effect of proximal femoral locking plate (PFLP) versus multiple cancellous screw (MCS) for FNF. Methods. FNF patients were treated with the PFLP implant or multiple cancellous screws (MCSs). Patient has been followed up for at least 12 months after surgery nonunion, and the occurrence of complications, femoral neck shortening, fracture healing time, and Harris hip score were recorded and compared. Results. 77 FNF patients were treated with the PFLP (36 patients) or MCS (41 patients). The sex, age, side of the injured limb, type of Garden fracture, time from injury to surgery, and fracture healing time of two groups patients were comparable. The operation time and intraoperative blood loss in the PFLP group were worse than those in the MCS group. Two patients with the PFLP (5%) and nine patients (21%) with the MCS experienced cut out of the lag screw or avascular necrosis of the femoral head or nonunion and received hip replacement. However, the number of fluoroscopies in the PFLP group was significantly lower than that in the MCS group. Additionally, the femoral neck shortening and Harris hip score were all strongly better in the PFLP group than in the MCS group. Conclusions. Compared with the MCS, PFLP treatment for FNF in young adults can decrease the fluoroscopy times, improve hip functional recovery, and reduce the complications rate and femoral neck shortening.

show abstract

Section: Discussionmentioning

confidence: 99%

A Comparative Study between Proximal Femoral Locking Plate and Multiple Cannulated Screws for Fixation of Femoral Neck Fractures in Young Adults

Zhang

Zhuang

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

show abstract

“…We believe that the shear force of the femoral neck after internal fixation is the key to the healing of the femoral neck. Although many studies have shown that the compression and fretting of the fracture end can promote healing, for the femoral neck, this theoretical healing is under the premise that the shear force is effectively controlled [ 16 ]. This is because of the correlation between the medical compliance and disease cognition of the patient, living habits, and even work habits [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of hip joint function and analysis of risk factors for internal fixation failure after Femoral Neck System (FNS)

Zhang,

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Objective Analysis of the risk factors affecting hip function and complications after femoral neck system (FNS) surgery for femoral neck fractures is of great significance for improving the procedure’s efficacy. Methods The data of patients with femoral neck fractures who underwent FNS surgery in our hospital between October 2019 and October 2020 were retrospectively analyzed. Age, gender, time from injury to operation, fracture classification, operation time, fracture reduction, and postoperative weight-bearing time information were set as potential factors that may affect the results. Hip Harris scores were performed at 12 months postoperatively, and postoperative complication data (e.g., femoral head necrosis, nonunion, and femoral neck shortness) were collected. The risk factors affecting hip function and complications after FNS surgery were predicted using linear and logistic regression analyses. Results A total of 69 cases of femoral neck fracture were included, with an average age of 56.09 ± 11.50 years. The linear analysis demonstrated that the age and fracture type of the patients were the risk factors affecting the Harris score of the hip joint after FNS surgery. Older patients with displaced femoral neck fractures had an inferior postoperative hip function. In addition, fracture type, reduction of the femoral neck, and postoperative weight-bearing significantly impacted postoperative complications. Displaced fractures, negative fixation, and premature weight-bearing (< 6 weeks) were risk factors for postoperative complications. The Harris score of patients with a shortened femoral neck in the included cases was not significantly different from that of patients without shortening (P = 0.25). Conclusions Advanced age and fracture type are important evaluation indicators of the Harris score after FNS internal fixation of femoral neck fractures in young patients. Fracture type, fracture reduction, and postoperative weight-bearing time are risk factors for complications after FNS.

show abstract

“…However, these improvements neglect the conduction of tensile forces and increase tissue damage, with long-term clinical application still being controversial. Current research suggests that postoperative complications are related to treatment time, fracture type, and quality of reduction, with internal fixation itself being an independent risk factor for complications of femoral neck fractures [ 17 , 18 ]. Biomechanical factors of internal fixation for femoral neck fractures, including poor stability and stress concentration, are important contributors to nonunion and avascular necrosis of the femoral head [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of the therapeutic effect of a novel proximal femoral bionic intramedullary nail and traditional inverted triangle hollow screw on femoral neck fracture

Zhang,

Ren,

Yao

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

Objective A novel Proximal Femoral Bionic Nail (PFBN) has been developed by a research team for the treatment of femoral neck fractures. This study aims to compare the biomechanical properties of the innovative PFBN with those of the conventional Inverted Triangular Cannulated Screw (ITCS) fixation method through biomechanical testing. Methods Sixteen male femoral specimens preserved in formalin were selected, with the donors’ age at death averaging 56.1 ± 6.3 years (range 47–64 years), and a mean age of 51.4 years. The femurs showed no visible damage and were examined by X-rays to exclude diseases affecting bone quality such as tumors, severe osteoporosis, and deformities. The 16 femoral specimens were randomly divided into an experimental group (n = 8) and a control group (n = 8). All femurs were prepared with Pauwels type III femoral neck fractures, fixed with PFBN in the experimental group and ITCS in the control group. Displacement and stress limits of each specimen were measured through cyclic compression tests and failure experiments, and vertical displacement and strain values under a 600 N vertical load were measured in all specimens through vertical compression tests. Results In the vertical compression test, the average displacement at the anterior head region of the femur was 0.362 mm for the PFBN group, significantly less than the 0.480 mm for the ITCS group (p < 0.001). At the fracture line area, the average displacement for the PFBN group was also lower than that of the ITCS group (0.196 mm vs. 0.324 mm, p < 0.001). The difference in displacement in the shaft area was smaller, but the average displacement for the PFBN group (0.049 mm) was still significantly less than that for the ITCS group (0.062 mm, p = 0.016). The situation was similar on the posterior side of the femur. The average displacements in the head area, fracture line area, and shaft area for the PFBN group were 0.300 mm, 0.168 mm, and 0.081 mm, respectively, while those for the ITCS group were 0.558 mm, 0.274 mm, and 0.041 mm, with significant differences in all areas (p < 0.001). The average strain in the anterior head area for the PFBN group was 4947 μm/m, significantly less than the 1540 μm/m for the ITCS group (p < 0.001). Likewise, in the fracture line and shaft areas, the average strains for the PFBN group were significantly less than those for the ITCS group (p < 0.05). In the posterior head area, the average strain for the PFBN group was 4861 μm/m, significantly less than the 1442 μm/m for the ITCS group (p < 0.001). The strain conditions in the fracture line and shaft areas also showed the PFBN group was superior to the ITCS group (p < 0.001). In cyclic loading experiments, the PFBN fixation showed smaller maximum displacement (1.269 mm vs. 1.808 mm, p < 0.001), indicating better stability. In the failure experiments, the maximum failure load that the PFBN-fixated fracture block could withstand was significantly higher than that for the ITCS fixation (1817 N vs. 1116 N, p < 0.001). Conclusion The PFBN can meet the biomechanical requirements for internal fixation of femoral neck fractures. PFBN is superior in biomechanical stability compared to ITCS, particularly showing less displacement and higher failure resistance in cyclic load and failure experiments. While there are differences in strain performance in different regions between the two fixation methods, overall, PFBN provides superior stability.

show abstract

Factors influencing femoral neck fracture healing after internal fixation with dynamic locking plate

Cited by 10 publications

References 20 publications

A Comparative Study between Proximal Femoral Locking Plate and Multiple Cannulated Screws for Fixation of Femoral Neck Fractures in Young Adults

A Comparative Study between Proximal Femoral Locking Plate and Multiple Cannulated Screws for Fixation of Femoral Neck Fractures in Young Adults

Prediction of hip joint function and analysis of risk factors for internal fixation failure after Femoral Neck System (FNS)

Biomechanical comparison of the therapeutic effect of a novel proximal femoral bionic intramedullary nail and traditional inverted triangle hollow screw on femoral neck fracture

Contact Info

Product

Resources

About