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A new configuration of cannulated screw fixation in the treatment of vertical femoral neck fractures

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Abstract

Purpose

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.

Results

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).

Conclusion

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.

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Acknowledgments

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.

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Author notes

  1. Baokun Zhang and Jingwen Liu contributed equally in this article.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

    Baokun Zhang, Jingwen Liu, Yi Zhu & Wei Zhang

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  1. Baokun Zhang
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  2. Jingwen Liu
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  3. Yi Zhu
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  4. Wei Zhang
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Corresponding author

Correspondence to Wei Zhang.

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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.

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Zhang, B., Liu, J., Zhu, Y. et al. A new configuration of cannulated screw fixation in the treatment of vertical femoral neck fractures. International Orthopaedics (SICOT) 42, 1949–1955 (2018). https://doi.org/10.1007/s00264-018-3798-x

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  • DOI: https://doi.org/10.1007/s00264-018-3798-x

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