First clinical results of 1-year follow-up of the femoral neck system for internal fixation of femoral neck fractures

Background Closed reduction and internal fixation (CRIF) is the preferred treatment to retain the native joint and maintain optimal functionality in femoral neck fractures. Sliding hip screw (SHS) and cannulated hip screws (CHS) are established CRIF options. SHS offer high biomechanical stability, w...

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Published in:Archives of orthopaedic and trauma surgery 2022-12, Vol.142 (12), p.3755-3763
Main Authors: Stassen, Robert C., Jeuken, Ralph M., Boonen, Bert, Meesters, Berry, de Loos, Erik R., van Vugt, Raoul
Format: Article
Language:English
Subjects:
Age
Arthritis
Biomechanics
Body mass index
Closed reduction
Failure
Females
Fractures
Joint surgery
Medicine
Medicine & Public Health
Orthopedics
Osteoarthritis
Patients
Risk factors
Teaching hospitals
Trauma
Trauma Surgery
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Summary:Background Closed reduction and internal fixation (CRIF) is the preferred treatment to retain the native joint and maintain optimal functionality in femoral neck fractures. Sliding hip screw (SHS) and cannulated hip screws (CHS) are established CRIF options. SHS offer high biomechanical stability, whereas CHS are minimally invasive. These established systems have a 17–21% failure rate. The Femoral neck system (FNS) was recently developed to combine the advantages of both predecessors. The aim of this study was to describe the first clinical experience with this novel implant with special emphasis on the safety and efficacy. Methods During a 1-year period all patients in our level-2 trauma centre with a FNF indicated for CRIF were treated using the FNS and evaluated at 2, 6, 12 weeks, 6 months and 1 year postoperatively using patient and fracture characteristics, surgical notes and radiographic imaging. Results Thirty-four patients were included, mean age was 63 years (SD 8), 58.2% was female. Fractures were classified as Pauwels I ( n  = 10), Pauwels II ( n  = 15), Pauwels III ( n  = 9), Garden I ( n  = 1), Garden II ( n  = 17), Garden III ( n  = 12) and Garden IV ( n  = 4). Eight reoperations were reported after 1-year follow-up; osteosyntheses failed in 6 patients due to avascular necrosis ( n  = 4) and cut-out ( n  = 2). In two patients the implant was removed due to inexplicable pain. Age (
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-021-04216-0