Skip to main content

Advertisement

SpringerLink
Log in

Anteromedial femoral neck plate with cannulated screws for the treatment of irreducible displaced femoral neck fracture in young patients: a preliminary study

  • Original Paper
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Backgrounds

Although most displaced femoral neck fractures of young patients can be repositioned successfully by closed reduction, there are still some can not repositioned successfully by this way and open reductions are required. This type of fracture was defined as irreducible displaced femoral neck fracture in this study. The purpose of this study was to introduce a new technique using anteromedial femoral neck plate with cannulated screws fixation by open reduction for the treatment of irreducible displaced femoral neck fractures in young patients.

Methods

Totally 26 patients with irreducible displaced femoral neck fracture treated by this technique were retrospectively reviewed. This technique included three major steps: open reduction of femoral neck fracture was performed via the modified anterior approach of hip joint, anteromedial femoral neck plate was fixed to the femoral neck, and two cannulated compression screws were inserted in the femoral neck inside.

Results

All patients were followed up with an average of 18months (range 12–30 months). Radiological and clinical outcomes were evaluated. The fracture union was achieved in 24 patients (92.3%) with an average duration of 4.5 months (range 3.8–10 months). Nonunion was not observed in all cases. Avascular necrosis of femoral head was identified in two patients (7.7%). Clinical outcomes of 24 hips with satisfactory union were evaluated by the Harris Hip Scores (HHS), excellent outcomes were achieved in 20 cases (HHS ≧ 90), fair outcomes in 3 cases (80 ≦ HHS < 90), and poor outcome in 1 case (HHS < 80).

Conclusions

Anteromedial femoral neck plate with cannulated screws fixation by open reduction is an alternative therapeutic method for the irreducible displaced femoral neck fracture in young patients, with low incidence of complications including nonunion and avascular necrosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bensen AS, Jakobsen T, Krarup N. Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures. Int Orthop. 2014;38(6):1241–5.

    Article  Google Scholar 

  2. Liu Y, Tao X, Wang P, Zhang Z, Zhang W, Qi Q. Meta-analysis of randomised controlled trials comparing unipolar with bipolar hemiarthroplasty for displaced femoral-neck fractures. Int Orthop. 2014;38(8):1691–6.

    Article  Google Scholar 

  3. Gierer P, Mittlmeier T. Femoral neck fracture. Unfallchirurg. 2015;118(3):259–69.

    Article  CAS  Google Scholar 

  4. Davidovitch RI, Jordan CJ, Egol KA, Vrahas MS. Challenges in the treatment of femoral neck fractures in the nonelderly adult. J Trauma. 2010;68(1):236–42.

    Article  Google Scholar 

  5. Elgeidi A, El Negery A, Abdellatif MS, El Moghazy N. Dynamic hip screws and fibular strut graft for fixation of fresh femoral neck fracture with posterior comminution. Arch Orthop Trauma Surg. 2017;137(10):1363–9.

    Article  Google Scholar 

  6. Yu XB, Zhao DW, Zhong SZ, Liu BY, Wang BJ, Liu YP, Zhang Y, Cui DP, Fu DP, Xie H. Prospective and comparative analysis of internal fixation of femoral neck fractures with or without vascularized iliac graft in young adults. Orthopedics. 2013;36(2):132–8.

    Article  CAS  Google Scholar 

  7. Souder CD, Brennan ML, Brennan KL, Song J, Williams J, Chaput C. The rate of contralateral proximal femoral fracture following closed reduction and percutaneous pinning compared with arthroplasty for the treatment of femoral neck fractures. J Bone Joint Surg Am. 2012;94(5):418–25.

    Article  Google Scholar 

  8. Araujo TP, Guimaraes TM, Andrade-Silva FB, Kojima KE, Silva Jdos S. Influence of time to surgery on the incidence of complications in femoral neck fracture treated with cannulated screws. Injury. 2014;5:S36–S39.

    Google Scholar 

  9. Lin D, Lian K, Ding Z, Zhai W, Hong J. Proximal femoral locking plate with cannulated screws for the treatment of femoral neck fractures. Orthopedics. 2012;35(1):e1–e5.

    Google Scholar 

  10. Samsami S, Saberi S, Sadighi S, Rouhi G. Comparison of three fixation methods for femoral neck fracture in young adults: experimental and numerial investigations. J Med Biol Eng. 2015;35(5):566–79.

    Article  Google Scholar 

  11. Yu X, Zhao D, Huang S, Wang B, Zhang X, Wang W, Wei X. Biodegradable magnesium screws and vascularized iliac grafting for displaced femoral neck fracture in young adults. BMC Musculoskelet Disord. 2015;16:329.

    Article  Google Scholar 

  12. Chammout GK, Mukka SS, Carisson T, Neander GF, Stark AW, Skoldenberg OG. Total hip replacement versus open reduction and internal fixation of displaced femoral neck fractures: a randomized long-term follow-up study. J Bong Joint Surg Am. 2012;94(21):1921–8.

    Article  Google Scholar 

  13. Kapoor A, Deety LV, John VZ, Devadoss S, Devadoss A. Management of neglected femoral neck fractures and nonunion using a novel triple surgery combination: an Indian experience. Int J Low Extrem Wounds. 2012;11(1):49–58.

    Article  Google Scholar 

  14. Xie X, zhang C, Jin D, Chen S, Gao Y. Free vascularised fibular graft for neglected femoral neck fractures in young adults. Hip Int. 2012;22(3):319–23.

    Article  Google Scholar 

  15. Mathews V, Cabanela ME. Femoral neck nonunion treatment. Clin Orthop Relat Res. 2004;419:57–64.

    Article  Google Scholar 

  16. Kalra M, Anand S. Valgus intertrochanteric osteotomy for neglected femoral neck fractures in young adults. Int Orthop. 2001;25(6):363–6.

    Article  CAS  Google Scholar 

  17. Sen RK, Tripathy SK, Goyal T, Aggarwal S, Tahasildar N, Singh D, Singh AK. Osteosynthesis of femoral-neck nonunion with angle blade plate and autogenous fibular graft. Int Orthop. 2012;36(4):827–32.

    Article  Google Scholar 

  18. LeCroy CM, Rizzo M, Gunneson EE, Urbaniak JR. Free vascularized fibular bone grafting in the management of femoral neck nonunion in patients younger than fifty years. J Orthop Trauma. 2002;16(7):464–72.

    Article  Google Scholar 

  19. Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br. 1995;77(1):34–41.

    Article  CAS  Google Scholar 

  20. Perren SM. Physical and biological aspects of fracture healing with special reference to internal fixation. Clin Orthop Relat Res. 1979;138:175–96.

    Google Scholar 

  21. Claes LE, Heigele CA. Magnitudes of local stress and strain along bony surfaces predict the course and type of facture healing. J Biomech. 1999;32(3):255–66.

    Article  CAS  Google Scholar 

  22. Siavashi B, Aalirezaei A, Moosavi M, Golbakhsh MR, Savadkoohi D, Zehtab MJ. A comparative study between multiple cannulated screws and dynamic hip screw for fixation of femoral neck fracture in adults. Int Orthop. 2015;39(10):2069–71.

    Article  Google Scholar 

  23. Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choice in femoral neck fracture fixation in the non-elderly. Injury. 2015;46(3):445–52.

    Article  Google Scholar 

  24. Su Y, Chen W, Zhang Q, Li B, Li Z, Guo M, Pan J, Zhang Y. An irreducible variant of femoral neck fracture: a minimally traumatic reduction technique. Injury. 2011;42(2):140–5.

    Article  Google Scholar 

  25. Van Walsum ADP, Vroemen J, Janzing HMJ, Winkelhorst T, Kalsbeek J, Roerdink WH. Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures. Eur J Trauma Emerg Surg. 2017;43(4):475–80.

    Article  Google Scholar 

  26. Sevitt S. Avascular necrosis and revascularisation of the femoral head after intracapsular fractures: a combined arteriographic and histological necropsy study. J Bone Joint Surg Br. 1964;46:270–96.

    Article  CAS  Google Scholar 

  27. Dargan DP, Callachand F, Diamond OJ, Connolly CK. Three-year outcomes of intracapsular femoral neck fractures fixed with sliding hip screws in adults aged under sixty-five years. Injury. 2016;47(11):2495–500.

    Article  CAS  Google Scholar 

  28. Roerdink WH, Aalsma AM, Nijenbanning G, van Walsum AD. Initial promising results of the dynamic locking blade plate, a new implant for the fixation of intracapsular hip fractures: results of a pilot study. Arch Orthop Trauma Surg. 2011;131(4):519–24.

    Article  CAS  Google Scholar 

  29. Stromqvist B, Hansson LI, Palmer J, Ceder L, Thorngren KG. Scintimetric evaluation of nailed femoral neck fractures with special reference to type of osteosynthesis. Acta Orthop Scand. 1983;54(3):340–7.

    Article  CAS  Google Scholar 

  30. Linde F, Andersen E, Hvass I, Madsen F, Pallesen R. Avascular femoral head necrosis following fracture fixation. Injury. 1986;17(3):159–63.

    Article  CAS  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Baoan Central Hospital of Shenzhen, the 5th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518102, Guangdong, China

    Linbo Zhuang, Lisheng Wang, Dongming Xu & Zhiyong Wang

Authors
  1. Linbo Zhuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dongming Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhiyong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linbo Zhuang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhuang, L., Wang, L., Xu, D. et al. Anteromedial femoral neck plate with cannulated screws for the treatment of irreducible displaced femoral neck fracture in young patients: a preliminary study. Eur J Trauma Emerg Surg 45, 995–1002 (2019). https://doi.org/10.1007/s00068-018-0972-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-018-0972-1

Keyword

Search

Navigation