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Bone impregnated hip screw in femoral neck fracture

Clinicoradiological results

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Abstract

Background: Femoral neck fractures are treated either by internal fixation or arthroplasty. Usually, cannulated cancellous screws are used for osteosynthesis of fracture neck of femur. The bone impregnated hip screw (BIHS) is an alternative implant, where osteosyntehsis is required in femoral neck fracture.

Materials and Methods: The BIHS is a hollow screw with thread diameter 8.3 mm, shank diameter 6.5 mm and wall thickness 2.2 mm and holes in the shaft of the screw with diameter 2 mm, placed in a staggered fashion. Biomechanical and animal experimental studies were done. Clinical study was done in two phases: Phase 1 in a group of volunteers, only with BIHS was used in a pilot study and phase 2 comparative study was done in a group with AO cannulated screws and the other group treated with BIHS.

Results: In the phase 1 study, out of 15 patients, only one patient had delayed union. In phase 2, there were 78 patients, 44 patients in BIHS showed early union, compared to the rest 34 cases of AO cannulated screws Out of 44 patients with BIHS, 41 patients had an excellent outcome, 2 had nonunions and one implant breakage was noted.

Conclusions: Bone impregnated hip screw has shown to provide early solid union since it incorporates the biomechanical principles and also increases the osteogenic potential and hence, found superior to conventional cannulated cancellous screw.

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References

  1. Bonnaire FA, Weber AT. Analysis of fracture gap changes, dynamic and static stability of different osteosynthetic procedures in the femoral neck. Injury 2002;33 Suppl 3:C24–32.

    Article  Google Scholar 

  2. Stankewich CJ, Chapman J, Muthusamy R, Quaid G, Schemitsch E, Tencer AF, et al. Relationship of mechanical factors to the strength of proximal femur fractures fixed with cancellous screws. J Orthop Trauma 1996;10:248–57.

    Article  CAS  Google Scholar 

  3. Meyers MH, Harvey JP Jr, Moore TM. The muscle pedicle bone graft in the treatment of displaced fractures of the femoral neck: Indications, operative technique, and results. Orthop Clin North Am 1974;5:779–92.

    CAS  PubMed  Google Scholar 

  4. Beris AE, Payatakes AH, Kostopoulos VK, Korompilias AV, Mavrodontidis AN, Vekris MD, et al. Nonunion of femoral neck fractures with osteonecrosis of the femoral head: Treatment with combined free vascularized fibular grafting and subtrochanteric valgus osteotomy. Orthop Clin North Am 2004;35:335–43, ix.

    Article  Google Scholar 

  5. Mullis BH, Johnson SD, Veillette C. Ortho OneAssistan Surgical Management of Femoral Neck Fractures. Orthopaedics One Articles. In: Orthopaedics One-the Orthopaedic Knowledge Network. Created Jun 05, 2010 12:17. Last modified Aug 16, 2012 05:31 ver. 20. [Last retrieved on 2014 02-03].

    Google Scholar 

  6. Johnson KD, Brock G. A review of reduction and internal fixation of adult femoral neck fractures in a county hospital. J Orthop Trauma 1989;3:83–96.

    Article  CAS  Google Scholar 

  7. Gerber C, Strehle J, Ganz R. The treatment of fractures of the femoral neck. Clin Orthop Relat Res 1993:77–86.

    Google Scholar 

  8. Dedrick DK, Mackenzie JR, Burney RE. Complications of femoral neck fracture in young adults. J Trauma 1986;26:932–7.

    Article  CAS  Google Scholar 

  9. Bachiller FG, Caballer AP, Portal LF. Avascular necrosis of the femoral head after femoral neck fracture. Clin Orthop Relat Res 2002:87–109.

    Google Scholar 

  10. Trueta J, Harrison MH. The normal vascular anatomy of the femoral head in adult man. J Bone Joint Surg Br 1953;35-B: 442–61.

    Article  CAS  Google Scholar 

  11. Garden RS. Malreduction and avascular necrosis in subcapital fractures of the femur. J Bone Joint Surg Br 1971;53:183–97

    Article  CAS  Google Scholar 

  12. Swiontkowski MF, Tepic S, Rahn BA, Cordey J, Perren SM. The effect of fracture on femoral head blood flow. Osteonecrosis and revascularization studied in miniature swine. Acta Orthop Scand 1993;64:196–202.

    Article  CAS  Google Scholar 

  13. 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 

  14. Arnoldi CC, Lemperg RK. Fracture of the femoral neck. II. Relative importance of primary vascular damage and surgical procedure for the development of necrosis of the femoral head. Clin Orthop Relat Res 1977:217–22.

    Google Scholar 

  15. Arnoldi CC, Linderholm H. Fracture of the femoral neck. I. Vascular disturbances in different types of fractures, assessed by measurements of intraosseous pressures. Clin Orthop Relat Res 1972;84:116–27.

    Article  CAS  Google Scholar 

  16. Swiontkowski MF, Tepic S, Perren SM, Moor R, Ganz R, Rahn BA. Laser Doppler flowmetry for bone blood flow measurement: Correlation with microsphere estimates and evaluation of the effect of intracapsular pressure on femoral head blood flow. J Orthop Res 1986;4:362–71.

    Article  CAS  Google Scholar 

  17. Maruenda JI, Barrios C, Gomar-Sancho F. Intracapsular hip pressure after femoral neck fracture. Clin Orthop Relat Res 1997:172–80.

    Google Scholar 

  18. Barnes R, Brown JT, Garden RS, Nicoll EA. Subcapital fractures of the femur. A prospective review. J Bone Joint Surg Br 1976;58:2–24.

    Article  CAS  Google Scholar 

  19. Zetterberg C, Elmerson S, Andersson GB. Epidemiology of hip fractures in Göteborg, Sweden, 1940-1983. Clin Orthop Relat Res 1984:43–52.

    Google Scholar 

  20. Bartonfcek J. Pauwels’ classification of femoral neck fractures: Correct interpretation of the original. J Orthop Trauma 2001;15:358–60.

    Article  Google Scholar 

  21. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737–55.

    Article  CAS  Google Scholar 

  22. Morwessel R, Evarts CM. The use of quadratus femoris muscle pedicle bone graft for the treatment of displaced femoral neck fractures. Orthopedics 1985;8:972–6.

    CAS  PubMed  Google Scholar 

  23. Hartford JM, Patel A, Powell J. Intertrochanteric osteotomy using a dynamic hip screw for femoral neck nonunion. J Orthop Trauma 2005;19:329–33.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  25. Anglen JO. Intertrochanteric osteotomy for failed internal fixation of femoral neck fracture. Clin Orthop Relat Res 1997:175–82.

    Google Scholar 

  26. Schoenfeld AJ, Vrabec GA. Valgus osteotomy of the proximal femur with sliding hip screw for the treatment of femoral neck nonunions: The technique, a case series, and literature review. J Orthop Trauma 2006;20:485–91.

    Article  Google Scholar 

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Correspondence to Amish Sunder Pattathil.

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Sundar Raj, P.K., Nuuman, J.A. & Pattathil, A.S. Bone impregnated hip screw in femoral neck fracture. IJOO 49, 187–192 (2015). https://doi.org/10.4103/0019-5413.152472

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