Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Yajun , MA Tao , ZHANG Xiaoyu , LUO Xiaojun , FAN Tao ,  WANG Yuhai

Orthopedics Center, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan Ningxia, 750001, P.R.China;

Corresponding author：

WANG Yuhai, Email: 398672611@qq.com

Keywords：

Femoral neck fracture; femoral neck system; cannulate screw; internal fixation

DOI：

10.7507/1002-1892.202012097

Video：

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Objective To investigate the short-term effectiveness of femoral neck system (FNS) in the treatment of femoral neck fracture.Methods The clinical data of 34 patients with femoral neck fracture admitted between January 2019 and April 2020 who met the selection criteria were retrospectively analyzed and divided into group A (19 patients were treated with conventional cannulated screw internal fixation) and group B (15 patients were treated with FNS internal fixation) according to the different methods of internal fixation. There was no significant difference between the two groups in general data such as gender, age, affected side, cause of injury, fracture type, and time from injury to operation (P>0.05). The operation time, intraoperative blood loss, fluoroscopy frequency, and fracture healing time were recorded and compared between the two groups. X-ray film and CT examinations were performed postoperatively to evaluate fracture reduction and internal fixation, and the shortening of the femoral neck on the affected side was measured compared with that on the healthy side. The Harris score was used to evaluate hip function.Results There was 1 unsatisfied reduction case in groups A and B respectively, the rest of the patients in both groups were obtained satisfied reduction. There was no significant difference in the quality of reduction between the two groups (Z=–0.195, P=0.854). There was no significant difference in operation time between the two groups (t=0.649, P=0.064). The intraoperative blood loss in group A was significantly less than that in group B, and the fluoroscopy frequency was significantly more than that in group B, with significant differences (P<0.05). Except for 1 case in group A with screw out at 3 months after operation and no obvious callus formation, all fractures in the two groups reached clinical healing, and there was no significant difference in fracture healing time between the two groups (t=–0.127, P=0.899). There was no necrosis of femoral head in the two groups. At last follow-up, there were 4 cases of femoral neck shortening in group A and 2 cases in group B. The hip function of both groups recovered well, and there was no significant difference in Harris score at last follow-up (t=0.956, P=0.346).Conclusion The treatment of femoral neck fracture using FNS has less trauma. Compared with cannulated screw internal fixation, it can reduce the intraoperative fluoroscopy frequency and obtain satisfactory short-term effectiveness.

Citation： YANG Yajun, MA Tao, ZHANG Xiaoyu, LUO Xiaojun, FAN Tao, WANG Yuhai. Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(5): 539-543. doi: 10.7507/1002-1892.202012097 Copy

1.	Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2.	Schopper C, Zderic I, Menze J, et al. Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels Ⅱ. J Orthop Translat, 2020, 24: 88-95.
3.	范智荣, 苏海涛, 周霖, 等. 新型股骨颈内固定系统治疗不稳定性股骨颈骨折的有限元分析. 中国组织工程研究, 2021, 25(15): 2321-2328.
4.	Campenfeldt P, Hedström M, Ekström W, et al. Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients. Injury, 2017, 48(12): 2744-2753.
5.	蔡乐益, 郭晓山, 郑文浩, 等. 对Garden指数作为股骨颈骨折复位质量评价标准的再认识. 中华创伤骨科杂志, 2020, 22(3): 232-237.
6.	刘克敏, 曲铁兵. 重视老年髋部骨折治疗和康复模式转变. 中华创伤杂志, 2018, 34(7): 577-579.
7.	李建涛, 张里程, 徐高翔, 等. 股骨近端三角形结构重建失效对骨折手术失败的影响. 中华骨科杂志, 2020, 40(14): 928-935.
8.	毕郑刚, 王旭明. 再谈老年股骨颈骨折的手术治疗策略. 中华外科杂志, 2019, 57(11): 804-806.
9.	杨宗酉, 邢欣, 张奇, 等. 股骨颈骨折诊断和治疗关键技术研究进展. 中华创伤杂志, 2014, 30(3): 274-276.
10.	Duffin M, Pilson HT. Technologies for young femoral neck fracture fixation. J Orthop Trauma, 2019, 33 Suppl 1: S20-S26.
11.	Slobogean GP, Stockton DJ, Zeng BF, et al. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC). Injury, 2017, 48(8): 1837-1842.
12.	Li M, Cole PA. Anatomical considerations in adult femoral neck fractures: how anatomy influences the treatment issues? Injury, 2015, 46(3): 453-458.
13.	Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury, 2015, 46(3): 445-452.
14.	Stoffel K, Zderic I, Gras F, et al. Biomechanical evaluation of the femoral neck system in unstable pauwels Ⅲ femoral neck fractures: A comparison with the dynamic hip screw and cannulated screws. J Orthop Trauma, 2017, 31(3): 131-137.
15.	Li J, Zhao Z, Yin P, et al. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res, 2019, 14(1): 76.
16.	Ye Y, Chen K, Tian K, et al. Medial buttress plate augmentation of cannulated screw fixation in vertically unstable femoral neck fractures: Surgical technique and preliminary results. Injury, 2017, 48(10): 2189-2193.
17.	许新忠, 常菁, 余水生, 等. 股骨颈系统固定治疗股骨颈骨折的近期疗效分析. 中华创伤骨科杂志, 2020, 22(7): 624-627.
18.	Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
19.	李海波, 许圣茜, 汤雪霞, 等. 术前牵引对股骨颈骨折术后发生股骨头缺血性坏死的影响研究. 中国修复重建外科杂志, 2019, 33(6): 671-675.
20.	李伟龙, 余霄, 庞清江. 股骨颈骨折内固定术后股骨颈短缩的相关研究进展. 中华骨科杂志, 2016, 36(6): 378-384.

1. Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2. Schopper C, Zderic I, Menze J, et al. Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels Ⅱ. J Orthop Translat, 2020, 24: 88-95.
3. 范智荣, 苏海涛, 周霖, 等. 新型股骨颈内固定系统治疗不稳定性股骨颈骨折的有限元分析. 中国组织工程研究, 2021, 25(15): 2321-2328.
4. Campenfeldt P, Hedström M, Ekström W, et al. Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients. Injury, 2017, 48(12): 2744-2753.
5. 蔡乐益, 郭晓山, 郑文浩, 等. 对Garden指数作为股骨颈骨折复位质量评价标准的再认识. 中华创伤骨科杂志, 2020, 22(3): 232-237.
6. 刘克敏, 曲铁兵. 重视老年髋部骨折治疗和康复模式转变. 中华创伤杂志, 2018, 34(7): 577-579.
7. 李建涛, 张里程, 徐高翔, 等. 股骨近端三角形结构重建失效对骨折手术失败的影响. 中华骨科杂志, 2020, 40(14): 928-935.
8. 毕郑刚, 王旭明. 再谈老年股骨颈骨折的手术治疗策略. 中华外科杂志, 2019, 57(11): 804-806.
9. 杨宗酉, 邢欣, 张奇, 等. 股骨颈骨折诊断和治疗关键技术研究进展. 中华创伤杂志, 2014, 30(3): 274-276.
10. Duffin M, Pilson HT. Technologies for young femoral neck fracture fixation. J Orthop Trauma, 2019, 33 Suppl 1: S20-S26.
11. Slobogean GP, Stockton DJ, Zeng BF, et al. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC). Injury, 2017, 48(8): 1837-1842.
12. Li M, Cole PA. Anatomical considerations in adult femoral neck fractures: how anatomy influences the treatment issues? Injury, 2015, 46(3): 453-458.
13. Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury, 2015, 46(3): 445-452.
14. Stoffel K, Zderic I, Gras F, et al. Biomechanical evaluation of the femoral neck system in unstable pauwels Ⅲ femoral neck fractures: A comparison with the dynamic hip screw and cannulated screws. J Orthop Trauma, 2017, 31(3): 131-137.
15. Li J, Zhao Z, Yin P, et al. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res, 2019, 14(1): 76.
16. Ye Y, Chen K, Tian K, et al. Medial buttress plate augmentation of cannulated screw fixation in vertically unstable femoral neck fractures: Surgical technique and preliminary results. Injury, 2017, 48(10): 2189-2193.
17. 许新忠, 常菁, 余水生, 等. 股骨颈系统固定治疗股骨颈骨折的近期疗效分析. 中华创伤骨科杂志, 2020, 22(7): 624-627.
18. Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
19. 李海波, 许圣茜, 汤雪霞, 等. 术前牵引对股骨颈骨折术后发生股骨头缺血性坏死的影响研究. 中国修复重建外科杂志, 2019, 33(6): 671-675.
20. 李伟龙, 余霄, 庞清江. 股骨颈骨折内固定术后股骨颈短缩的相关研究进展. 中华骨科杂志, 2016, 36(6): 378-384.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture

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