Dataset Information

Definition of ideal configuration for femoral neck screw fixation in older people.

ABSTRACT: Femoral neck fractures are the most common injuries encountered by older individuals, and they are associated with high mortality and morbidity. Internal fixation to femoral neck fracture with cannulated screws placed with a configuration of an inverted triangle remain a feasible and effective treatment for femoral neck fractures. The objection of this research was to evaluate the femoral neck morphology, especially the shape of the femoral neck in Chinese people to find the optimal screw position and interval between the screws. 96 consecutive normal subjects without any previous proximal femur operation were reviewed. The patients' information were collected from our database. The minimum of neck canal height (NCHM), neck canal width (NCWM) and inclination angle (AIA and PIA) were measured in different level. There was a significant difference between the AIA and PIA, neck canal height at inferior and superior 1/3 on posterior wall (NCHIP and NCHSP). Although there was a significant difference between the neck canal height at inferior and superior 1/3 on anterior wall (NCHIA and NCHSA, p?

SUBMITTER: Guo J

PROVIDER: S-EPMC6733851 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Definition of ideal configuration for femoral neck screw fixation in older people.

Guo Jialiang J Dong Weichong W Qin Shiji S Zhang Yingze Y

Scientific reports 20190909 1

Femoral neck fractures are the most common injuries encountered by older individuals, and they are associated with high mortality and morbidity. Internal fixation to femoral neck fracture with cannulated screws placed with a configuration of an inverted triangle remain a feasible and effective treatment for femoral neck fractures. The objection of this research was to evaluate the femoral neck morphology, especially the shape of the femoral neck in Chinese people to find the optimal screw positi ...[more]

PMID: 31501449

Similar Datasets

Project description:ObjectiveTo investigate the effects of postoperative femoral neck shortening in patients with femoral neck fractures fixed with femoral neck system screws (FNS) and to explore the factors influencing femoral neck shortening.MethodTo retrospectively analyze the data of 113 patients with femoral neck fractures admitted to the Second Hospital of Fuzhou City, affiliated with Xiamen University, between December 2019 and January 2022. Of these, 87 patients were followed up for more than 12 months, 49 men and 38 women: 36 cases of Garden I and II fractures and 51 cases of Garden III and IV fractures, to record the patient's hip Harris score at 12 months postoperatively. Patients were divided into femoral neck shortening group and femoral neck no shortening group according to their regular postoperative follow-up radiographic measurements. To count the incidence of femoral neck shortening, a comparison of postoperative complication rates and hip Harris scores between the two groups was made. Statistical comparison of the two groups and a multifactorial logistic regression analysis were also performed to analyze the factors affecting femoral neck shortening.ResultsAll 87 patients were followed up for more than 12 months after surgery. In 34 of these cases, neck shortening occurred, and the incidence rate was 39.1%. 15 cases of severe shortening, incidence of 17.2%; fracture healing 84 cases, fracture healing rate of 96.5%. The hip Harris score was 83.99 (81.95, 89.20) in the neck shortening group at 12 months postoperatively, 90.87 (87.95, 94.80) for the group without neck shortening; the difference between the two groups was statistically significant (P < 0.01). 32 cases of fracture healing in the neck shortening group at 12 months after surgery, fracture healing rate of 94.1%; 52 cases healed without neck shortening group, fracture healing rate of 98.1%. The difference between the two groups was not statistically significant (P = 0.337). High incidence of neck shortening after FNS fixation of femoral neck fractures, cortical comminution of the severed end, fracture fractionation and quality of reduction were significantly correlated with neck shortening.ConclusionHigh incidence of postoperative neck shortening after internal fixation of femoral neck fractures with the femoral neck system, the cortical comminution, the type of fracture, and the quality of fracture reduction are the influencing factors; femoral neck shortening can affect postoperative hip function, but does not affect fracture healing.

Project description:ObjectiveTo compare the effects between computer-assisted and traditional cannulated screw internal fixation on treating femoral neck fracture.MethodsThe search was conducted in Embase, Pubmed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database from the beginning to August 2020. RevMan5.4 software, which was provided by the International Cochrane Group, was used for the meta-analysis comparing the differences in operation time, intraoperative bleeding volume, fluoroscopy frequency, fracture healing time, total drilling times, Harris score, fracture healing rate, and femoral head necrosis rate between computer-assisted and traditional methods groups.ResultsA total of 1028 patients were included in 16 studies. Primary outcome indicators: Compared with the traditional method group, the computer-assisted group had less operative time (2RCTs, P < 0.00001; 8 non-RCTs, P = 0.009; Overall, P < 0.00001), intraoperative bleeding (1 RCTs, P < 0.00001; 9non-RCTs, P < 0.00001; Overall, P < 0.00001), femoral head necrosis rate (1 RCT, P = 0.11;7 non-RCTs, P = 0.09; Overall, P = 0.02) and higher Harris scores (1 RCT, P < 0.0001; 9 non-RCTs, P = 0.0002; Overall, P < 0.0001), and there were no significant differences in fracture healing rate between the two groups (5 non-RCTs, P = 0.17). Secondary outcomes indicators: The computer-assisted group had a lower frequency of intraoperative fluoroscopy and total number of drills compared with the traditional method group, while there was no significant difference in fracture healing time.ConclusionCompared with the traditional hollow screw internal fixation on the treatment of femoral neck fracture, computer-assisted percutaneous cannulated screw fixation can shorten the operation time and improve the operation efficiency and reduce the X-ray injury of medical staff and help patients obtain a better prognosis. Therefore, computer-assisted percutaneous cannulated screw fixation is a better choice for the treatment of femoral neck fracture. Study registration PROSPERO registration number CRD42020214493.

Project description:BackgroundWe introduced a new surgical method of percutaneous hollow perforated screw (HPS) fixation with concomitant bone-cement injection for the treatment of femoral neck metastasis and evaluated its efficacy for the palliative treatment of patients with advanced cancer.MethodsThe study included 87 patients (39 men and 48 women; mean age [and standard deviation], 64.2 ± 10.2 years; mean body mass index, 24.3 ± 3.2 kg/m2) who underwent percutaneous HPS fixation and cementoplasty (mean cement amount, 19.8 ± 8.3 mL) for the treatment of unilateral or bilateral femoral neck metastasis (total, 95 sites). Anesthesia type, operative time, operative blood loss, pain score changes (according to a visual analog scale [VAS]), walking status, and complications were assessed. The mean duration of follow-up was 10.1 ± 10.8 months (range, 2 to 43 months).ResultsThe majority of procedures were performed with local (3 patients) or spinal (72 patients) anesthesia (total, 75 patients; 86.2%). The mean operative time was 35.9 minutes, and the mean operative blood loss was 97.0 mL. The VAS score for pain improved significantly, from 6.8 ± 2.8 preoperatively to 2.8 ± 2.3 and 2.9 ± 2.8 at 1 and 6 weeks postoperatively (p < 0.001). At 6 weeks postoperatively, 63 (80.8%) of 78 patients were able to walk (with either normal or limping gait, a cane or crutch, or a walker). The prevalence of major local complications (cement leakage into the hip joint, fixation failure) was 10.5% (10 of 95), but major systemic complications (distant cement embolism) were not found.ConclusionsPercutaneous HPS fixation and cementoplasty for the treatment of femoral neck metastasis is a minimally invasive technique that provides effective pain relief and early stabilization. This technique seems to be useful for patients with advanced cancer for whom open surgery would be hazardous.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Project description:ObjectiveSurgical treatment with internal fixation, specifically percutaneous fixation with three cannulated compression screws (CCSs), is the preferred choice for young and middle-aged patients. The mechanical advantage of the optimal spatial configuration with three screws provides maximum dispersion and cortical support. We suspect that the spatial proportion of the oblique triangle configuration (OTC) in the cross-section of the femoral neck isthmus (FNI) may significantly improve shear and fatigue resistance of the fixed structure, thereby stabilizing the internal fixation system in femoral neck fracture (FNF). This study aims to explore the mechanical features of OTC and provide a mechanical basis for its clinical application.MethodsTwenty Sawbone femurs were prepared as Pauwels type III FNF models and divided equally into two fixation groups: OTC and inverted equilateral triangle configuration (IETC). Three 7.3 mm diameter cannulated compression screws (CCSs) were used for fixation. The specimens of FNF after screw internal fixation were subjected to static loading and cyclic loading tests, respectively, with five specimens for each test. Axial stiffness, 5 mm failure load, ultimate load, shear displacement, and frontal rotational angle of two fragments were evaluated. In the cyclic loading test, the load sizes were 700 N, 1400 N, and 2100 N, respectively, and the fracture end displacement was recorded. Results were presented as means ± SD. Data with normal distributions were compared by the Student's t test.ResultsIn the static loading test, the axial stiffness, ultimate load, shear displacement, and frontal rotational angle of two fragments were (738.64 vs. 620.74) N/mm, (2957.61 vs. 2643.06) N, (4.67 vs. 5.39) mm, and (4.01 vs. 5.52)° (p < 0.05), respectively. Comparison between the femoral head displacement after 10,000 cycles of 700N cyclic loading and total displacement after 20,000 cycles of 700-1400N cyclic loading showed the OTC group was less than the IETC group (p < 0.05). A comparison of femoral head displacement after 10,000 cycles of 1400N and 2100N cycles and total displacement after 30,000 cycles of 700-2100N cycles showed the OTC group was less than another group, but the difference was not significant (p > 0.05).ConclusionWhen three CCSs are inserted in parallel to fix FNF, the OTC of three screws has obvious biomechanical advantages, especially in shear resistance and early postoperative weight-bearing, which provides a mechanical basis for clinical selection of ideal spatial configuration for unstable FNF.

Dataset Information

Definition of ideal configuration for femoral neck screw fixation in older people.

Publications

Definition of ideal configuration for femoral neck screw fixation in older people.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets