scholarly journals Comparison of Ordinary Cannulated Compression Screw and Double-Head Cannulated Compression Screw Fixation in Vertical Femoral Neck Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yuelei Zhang ◽  
Chao Yan ◽  
Lecheng Zhang ◽  
Wei Zhang ◽  
Gang Wang
Keyword(s):  
Femoral Neck ◽  
Maximum Load ◽  
Femoral Neck Fractures ◽  
Axial Stiffness ◽  
Screw Loosening ◽  
Compression Screw ◽  
Fixation Failure ◽  
Fracture Displacement ◽  
Load To Failure ◽  
Double Head

Background. The treatment of vertical femoral neck fractures in young patients remains a challenge. This study is aimed at comparing ordinary cannulated compression screw (OCCS) and double-head cannulated compression screw (DhCCS) fixation in vertical femoral neck fractures both clinically and biomechanically. Materials and Methods. Clinically, the radiographs of 81 patients with Pauwel’s III femoral neck fractures, including 54 fractures fixed with three parallel OCCSs and 27 fractures fixed with three parallel DhCCSs, were reviewed retrospectively. Complications consisting of fixation failure (screw loosening, obvious fracture displacement, varus deformity, or femoral neck shortening), bony nonunion, and avascular necrosis (AVN) were determined. Biomechanically, twenty synthetic femur models of vertical femoral fractures with an 80° Pauwel’s angle were divided into two groups and subsequently fixed with three parallel OCCSs or DhCCSs. All specimens were tested for axial stiffness, load to 5 mm displacement, and a maximum load to failure with a loading rate of 2 mm/min. Results. Clinically, 22 fractures in the OCCS group experienced fixation failure, including 19 screw loosening, 18 femoral neck shortening, 14 varus deformities, and 8 obvious fracture displacements, whereas only 4 fractures experienced fixation failure in the DhCCS group, including 3 screw loosening, 3 femoral neck shortening, 3 varus deformities, and 1 obvious fracture displacement. Additionally, 11 fractures in the OCCS group exhibited nonunion, whereas only 3 in the DhCCS group exhibited nonunion. Nine fractures with AVN were noted in the OCCS group, whereas only 1 was observed in the DhCCS group. Biomechanically, the axial stiffness of the DhCCS group was greater than that of the OCCS group ( 154.9 ± 6.81 vs. 128.1 ± 7.41  N/mm), and the load to 5 mm displacement was also significantly greater in the DhCCS group ( 646.1 ± 25.87 vs. 475.8 ± 21.46  N). Moreover, the maximum load to failure in the DhCCS group exhibited significant advantages compared with that of the OCCS group ( 1148 ± 39.47 vs. 795.9 ± 51.39  N). Conclusion. Our results suggested that using three DhCCSs improved the outcome of vertical femoral neck fractures compared to three OCCSs, offering a new choice for the treatment of femoral neck fracture.

scholarly journals A comparative study of partial-threaded cannulated screws and double-threaded cannulated screws in the fixation of vertical femoral neck fractures

2020 ◽  
Author(s):  
Yuelei Zhang ◽  
Gang Wang ◽  
Wei Zhang
Keyword(s):  
Femoral Neck ◽  
Varus Deformity ◽  
Maximum Load ◽  
Femoral Neck Fractures ◽  
Vertical Shear ◽  
Axial Stiffness ◽  
Cannulated Screws ◽  
Fixation Failure ◽  
Fracture Displacement ◽  
Neck Fracture

Abstract Background This study purposed to compare the partial- threaded cannulated screws (PTCS) and the double-threaded cannulated screws (DTCS) in vertical shear femoral neck fractures both clinically and biomechanically. Methods Clinally, the radiographs of 81 patients with Pauwels Ⅲ femoral neck fractures, including 54 fractures fixed with PTCS and 27 fractures fixed with DTCS were analyzed. Complications consist of fixation failure (nail withdrawal, obvious fracture displacement, varus deformity or femoral neck shortening), bony nonunion and avascular necrosis (AVN) were determined. Biomechanically, twenty femur synthetic bones were equally divided and made to a vertical femoral neck fracture model, then fixed with three parallel PTCSs or DTCSs respectively. All specimens were tested for axial stiffness and a maximum load to failure with a loading rate of 2 mm/min. Results Clinically , 22 fractures in the PTCS group experienced fixation failure, including 19 nail withdrawal, 18 femoral neck shortening, 14 varus deformity and 8 obvious fracture displacement; while only 5 fractures showed up with fixation failure in the DTCS group, including 3 nail withdrawal, 4 femoral neck shortening, 4 varus deformity and 1 obvious fracture displacement. Additionally, 11 fractures in the PTCS group had nonunion while only 3 in the DTCS group and 9 fractures with AVN in the PTCS group while only 2 in the DTCS group. Biomechanically, The axial stiffness of DTCS was 152.89±22.74 N/mm, greater than PTCS (134.68±26.61), moreover, the failure load in DTCS was significantly greater than PTCS (1148.11±124.80 vs 795.88±162.50). Conclusion DTCS may exert more advantages than PTCS for vertical femoral neck fractures, including stronger fixation stability, lower rate of fixation failure and nonunion.

scholarly journals Ordinary Cannulated Compression Screws or Headless Cannulated Compression Screws? A Synthetic Bone Biomechanical Research in the Internal Fixation of Vertical Femoral Neck Fracture

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Baokun Zhang ◽  
Jingwen Liu ◽  
Wei Zhang
Keyword(s):  
Compressive Strength ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Maximum Load ◽  
Biomechanical Stability ◽  
Compression Screw ◽  
Significant Difference ◽  
Load To Failure ◽  
Neck Fracture ◽  
3D Printed

Purpose. The purpose of this study is to verify whether the headless cannulated compression screw (HCCS) has higher biomechanical stability than the ordinary cannulated compression screw (OCCS) in the treatment of vertical femoral neck fractures. Materials and Methods. 30 synthetic femur models were equally divided into 2 groups, with 50°, 60°, and 70° Pauwels angle of femoral neck fracture, under 3D printed guiding plates and C-arm fluoroscopic guidance. The femur molds were fixed with three parallel OCCSs as OCCS group and three parallel HCCSs as HCCS group. All specimens were tested for compressive strength and maximum load to failure with a loading rate of 2 mm/min. Results. The result showed that there was no significant difference with the compressive strength in the Pauwels angle of 50° and 60°. However, we observed that the maximum load to failure with the Pauwels angle of 50°, 60°, and 70° and the compressive strength with 70° of HCCS group showed better performance than the OCCS group. Conclusion. HCCS performs with better biomechanical stability than OCCS in the treatment of vertical femoral neck fracture, especially with the Pauwels angle of 70°.

scholarly journals Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture

2016 ◽  
Vol 98 (6) ◽  
pp. 376-379 ◽  
Author(s):  
O Riaz ◽  
R Arshad ◽  
S Nisar ◽  
R Vanker
Keyword(s):  
Femoral Neck ◽  
Serum Albumin ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Fixation Failure ◽  
Non Union ◽  
Preoperative Serum ◽  
Neck Fracture ◽  
Posterior Tilt ◽  
Intracapsular Femoral Neck Fracture

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%–19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60–101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.

scholarly journals Internal fixation of femoral neck fractures: Compression screw compared with nail plate fixation

1984 ◽  
Vol 55 (4) ◽  
pp. 423-429 ◽  
Author(s):  
Svein Svenningsen ◽  
Pål Benum ◽  
Olav Nesse ◽  
Odd Ivar Furset
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Nail Plate ◽  
Femoral Neck Fractures ◽  
Compression Screw

Analysis of Affecting Factors of Fixation Failure of Femoral Neck Fractures Using Internal Fixation

2006 ◽  
Vol 19 (3) ◽  
pp. 297 ◽  
Author(s):  
Soo Jae Yim ◽  
Seung Han Woo ◽  
Min Young Kim ◽  
Jong Seok Park ◽  
Eung Ha Kim ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Femoral Neck Fractures ◽  
Affecting Factors ◽  
Fixation Failure

Treatment of Femoral Neck Fractures With the Sliding Compression Screw

1982 ◽  
Vol &NA; (163) ◽  
pp. 137???140
Author(s):  
FREDERICK D. RAU ◽  
ARTHUR MANOLI ◽  
LAWRENCE G. MORAWA
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Compression Screw

Quality of Life Related to Fracture Displacement Among Elderly Patients With Femoral Neck Fractures Treated With Internal Fixation

2003 ◽  
Vol 17 (SUPPLEMENT) ◽  
pp. S17-S21 ◽  
Author(s):  
Jan Tidermark ◽  
Niklas Zethraeus ◽  
Olle Svensson ◽  
Hans Törnkvist ◽  
Sari Ponzer
Keyword(s):  
Quality Of Life ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Femoral Neck Fractures ◽  
Fracture Displacement

Fixation Failure in Femoral Neck Fractures

2002 ◽  
Vol 399 ◽  
pp. 110-118 ◽  
Author(s):  
Lance S. Estrada ◽  
David A. Volgas ◽  
James P. Stannard ◽  
Jorge E. Alonso
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Fixation Failure
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