Valgus-impacted femoral neck fractures (OTA 31B1.1 and 31B1.2) are considered stable fractures with favorable outcomes compared to displaced fractures. However, complications such as femoral neck shortening, screw sliding, and suboptimal recovery can occur, particularly in severe deformities. This study evaluated the outcomes of a sequential fixation technique using short-threaded screws followed by long-threaded screws. This prospective study included 135 patients aged 60 years or older with valgus-impacted femoral neck fractures (OTA 31B1.1 and 31B1.2) treated between March 2017 and February 2021. Patients were divided into two groups: those treated solely with short-threaded screws (the control group) and those treated using a sequential fixation technique involving initial compression with short-threaded screws followed by stabilization with long-threaded screws. Exclusion criteria included follow-up < 12 months, pathological fractures, high-energy trauma, or periprosthetic fractures. Clinical outcomes, including the Harris Hip Score (HHS), and radiological parameters, such as screw sliding distance (SDS) and fixation failure, were analyzed. Multivariate regression identified predictors of outcomes to assess the effectiveness of the sequential fixation technique. The mean follow-up was 38.3 months. Multivariate regression revealed that posterior tilt > 15° (β = 2.944, < 0.001) and the use of long-threaded screws (β = -1.906, < 0.001) were significant predictors of reduced SDS. Posterior tilt > 15° (OR 15.085, = 0.002), valgus tilt > 15° (OR 28.616, = 0.002), and bone mineral density (OR 0.285, = 0.005) were predictors of fixation failure, while long-threaded screws significantly reduced fixation failure risk (OR 0.062, = 0.005). The sequential use of short-threaded screws for compression, followed by long-threaded screws for stabilization, effectively reduced screw sliding and fixation failure while improving functional and radiological outcomes. This technique shows promise as an effective treatment for valgus-impacted femoral neck fractures.
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http://dx.doi.org/10.3390/medicina61010040 | DOI Listing |
Medicina (Kaunas)
December 2024
Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea.
Valgus-impacted femoral neck fractures (OTA 31B1.1 and 31B1.2) are considered stable fractures with favorable outcomes compared to displaced fractures.
View Article and Find Full Text PDFJ Orthop Surg Res
May 2021
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
Background: Preoperative posterior tilt is a risk factor for fixation failure in femoral neck fractures. This study aimed to evaluate the configuration of anterior positioning screw in proximal femoral plating in the treatment of retroverted femoral neck fractures in terms of resisting posterior tilt.
Methods: We retrospectively analyzed patients with retroverted femoral neck fractures who were fixed by proximal femoral plating from January 2014 to August 2019.
Injury
August 2021
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China; Shanghai Trauma Emergency Center, Shanghai, 200072, China; Orthopedic Intelligent Minimally Invasive Diagnosis & Treatment Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China. Electronic address:
Objectives: Proximal femoral plating serves as a good alternative for the fixation of femoral neck fractures, but fixation loss still occurs. This study aimed to evaluate the effect of a hybrid configuration of short- and long-threaded cannulated screws in proximal femoral plating in terms of decreasing varus collapse of femoral neck fractures.
Materials And Methods: We retrospectively analyzed 86 patients with femoral neck fractures who were fixed by proximal femoral plating from January 2015 to June 2019.
Injury
April 2010
Orthopaedic Department, Peterborough and Stamford Hospital NHS Foundation Trust, Peterborough District Hospital, Thorpe Road, Peterborough PE3 6DA, UK.
It is unclear which length of thread may be most advantageous for the internal fixation of an intracapsular fracture with cancellous screws. We have compared the 16 mm versus the 32 mm threads on cancellous screws within a randomised trial for 432 patients. All fractures were fixed with three screws and patients followed-up for a minimum of one year from injury.
View Article and Find Full Text PDFSpine (Phila Pa 1976)
February 2000
Department of Orthopedic Surgery, Changhai Hospital, Shanghai, People's Republic of China.
Study Design: An in vitro biomechanical study of posterior lumbar interbody fusion (PLIF) with threaded cages was performed on 18 bovine lumbar functional spinal units.
Objectives: To compare the segmental stiffness among PLIF with a single long posterolateral cage, PLIF with a single long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages.
Summary Of Background Data: In most cases, PLIF with threaded cage techniques needs bilateral facetectomy, extensive exposure, and retraction of the cauda equina.
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