Open Reduction in Femoral Neck Fractures

Overview

Outcomes of open reduction and internal fixation of femoral neck fractures using dynamic hip screw versus cannulated screws combined with medial buttress plate.

-Femoral neck fractures (FNFs) in patients under the age of 50 years account for less than 5% of all hip fractures and are typically the result of a high-energy event. FNFs in young patients, particularly displaced fractures, are challenging to treat. Internal fixation remains the consensus, and the quality of the reduction is more important than the time to surgery. Femoral head necrosis and fracture nonunion have always been the two major complications of femoral neck fracture treatment, which greatly increases the difficulty of treatment and places a high burden on social and medical resources. As previous studies have demonstrated, reoperation rate for a failure of internal fixation ranges from 10% to 48.8% and has remained largely unchanged over the past 30 years. There are many options to treat femoral neck fracture. Previous studies reported that femoral neck fractures with following surgery are associated implant failure. Currently, the most common types of fixation include cannulated screws, hip screw systems, proximal femur plates, and cephalomedullary nails. \[7\] Arthroplasty may be an option for elderly patients, but is generally not feasible for young patients; young patients with FNF require a more durable and promising fixation. However, there is no consensus on the best fixation method for FNF in young patients. CS has better biomedical properties such as anti-rotation and less invasive, which was widely used in non-displaced intracapsular fractures. DHS could maintain the neck-shaft angle and anatomical reduction, which is helpful for fracture fixation. A medial buttress plate can clamp the fracture apex, neutralize shearing forces, and transfer them into compressive forces into the plane of cannulated screws or other typical construct. Thus far, there has been no optimal internal fixation method.

Conditions

Interventions

Eligibility

Locations (1)

Outcomes