A new configuration of cannulated screw fixation in the treatment of vertical femoral neck fractures
- 162 Downloads
The treatment of vertical femoral neck fractures in young patients is a worldwide challenge. The purpose of this study is to introduce a new configuration of cannulated screw fixation in vertical femoral neck fractures by comparing with using ordinary cannulated compression screw (OCCS) alone biomechanically and clinically.
Material and method
Biomechanically, 20 synthetic femur models of femoral neck fractures with 20° of VN angle were divided into two groups. The first group was fixed with three ordinary cannulated compression screws defined as OCCS group; the second group was fixed with two Headless Cannulated Compression Screws (HCCS) plus an OCCS, defined as combination group and tested for axial stiffness and load to failure. Clinically, a prospective study was designed with 59 patients who have vertical femoral neck fractures and were treated with cannulated screw, including 31 patients with three ordinary cannulated compression screws alone and 28 patients with an ordinary cannulated compression screw plus two headless cannulated compression screws.
Biomechanically, our results showed that there was no significant difference of axial stiffness between OCCS group and combination group (109.92 ± 10.81 vs. 123.49 ± 15.13 N/mm, P = 0.145). But, the maximum load to failure of the combination group performed significant advantages than that of the OCCS group (446.85 ± 76.25 vs. 302.92 ± 80.46 N, P = 0.007). Clinically, the rates of fixation failure in the group treated with OCCS alone were 41.9%, while in the group treated with two types of screws were14.3% (P = 0.048).
Our results suggested that using new configuration of an OCCS plus two HCCSs improved the outcome of vertical femoral neck fractures (FNF) patients compared to those using OCCS alone, which provides a new choice for treatment of FNF.
KeywordsVertical Femoral neck fracture Cannulated screws
We thank the staff of Sports Biomechanics Laboratory in Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and colleagues who provided us a lot of useful inspiration.
Compliance with ethical standards
Conflict of interest
The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article and no conflict outside the current study.
- 8.Rupprecht M, Grossterlinden L, Ruecker AH, de Oliveira AN, Sellenschloh K, Nuchtern J, Puschel K, Morlock M, Rueger JM, Lehmann W (2011) A comparative biomechanical analysis of fixation devices for unstable femoral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw. J Trauma 71:625–634CrossRefPubMedGoogle Scholar
- 10.Zlowodzki M, Brink O, Switzer J, Wingerter S, Woodall J Jr, Petrisor BA, Kregor PJ, Bruinsma DR, Bhandari M (2008) The effect of shortening and varus collapse of the femoral neck on function after fixation of intracapsular fracture of the hip: a multi-centre cohort study. J Bone Joint Surg Br 90:1487–1494CrossRefPubMedGoogle Scholar