Comparing the Efficiency of the Femoral Neck System and the Cannulated Compression Screw in Treating Femoral Neck Fractures in Patients Who Are Young and Middle-aged Indian Population

Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 16-20 | Arvind Vatkar, Sachin Kale, Gaurav Kanade, Ashok Godke, Joydeep K. Dey, Rahul Godke, Nrupam Mehta, Sonali Das

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.584


Authors: Arvind Vatkar [1], Sachin Kale [1], Gaurav Kanade [2], Ashok Godke [3], Joydeep K. Dey [4], Rahul Godke [4], Nrupam Mehta [3], Sonali Das [4]

[1] Department of Orthopaedics, Apollo Hospital, Belapur, Navi Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, MGM Hospital, Kamothe, Navi Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India.
[4] Department of Orthopaedic, Matoshree Hospital, Panvel, Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Arvind Vatkar,
Consultant Spine Surgeon, Department of Orthopaedics, Apollo Hospital, Belapur, Navi Mumbai, Maharashtra, India.
E-mail: vatkararvind@gmail.com


Abstract

Background: There are no long-term studies regarding the clinical effectiveness of a novel fixation technique (femoral neck system [FNS]) for femoral neck fractures. The primary aim of this study was to compare the effectiveness of two internal fixation techniques (FNS and cannulated compression screw [CCS]) for treating femoral neck fractures in individuals between the ages of 20 and 40 years.
Materials and Methods: Data of patients who underwent internal fixation surgery for femoral neck fractures in our hospital between January 2018 and January 2020 with CCS and between January 2020 and January 2022 with FNS were retrospectively evaluated. The groups of CCS and FNS were separated based on the various internal fixation techniques. Demographics about all patients, including sex, age, body mass index, and fracture type were recorded. Pre-operative and 1-year post-operative follow-up of patients was to assess femoral neck shortenings and the Harris Hip score was used to evaluate joint function. Post-operative complications such as femoral head necrosis, non-union, and femoral neck shortening were noted.
Results: 30 patients each of CCS and FNS system fixation were enrolled in the study. The male-to-female ratio was 21:9 and 18:12 for CCS and FNS, respectively. The average age of both groups was around 30 years. Compared to patients treated with CC screws, patients who had FNS treatment required less time to recuperate and resume normal activities. The HSS score improvement at 2 weeks and 12 weeks was significantly better in the FNS system than CCS fixation. There was improvement in flexion, abduction, and external rotation range of motion in FNS compared to CCS. There was no statistically significant difference between the two groups in the incidence of femoral head necrosis or fracture non-union following surgery.
Conclusion: Patients treated with FNS for femoral neck fractures in the age range of 20–40 years can achieve better hip scores than CCS fixation and also have improved range of motion in flexion, abduction, and external rotation.
Keywords: Femoral neck system, cannulated cancellous screw, femoral neck fractures, harris hip score


References

1. Ly TV, Swiontkowski MF. Treatment of femoral neck fractures in young adults. J Bone Joint Surg Am 2008;90:2254-66.
2. Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury 2002;33 Suppl 3:C1-7.
3. Protzman RR, Burkhalter WE. Femoral-neck fractures in young adults. J Bone Joint Surg Am 1976;58:689-95.
4. Chandler HP, Reineck FT, Wixson RL, McCarthy JC. Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J Bone Joint Surg Am 1981;63:1426-34.
5. Schaller F, Sidelnikov E, Theiler R, Egli A, Staehelin HB, Dick W, et al. Mild to moderate cognitive impairment is a major risk factor for mortality and nursing home admission in the first year after hip fracture. Bone 2012;51:347-52.
6. Morri M, Chiari P, Forni C, Orlandi Magli A, Gazineo D, Franchini N, et al. What factors are associated with the recovery of autonomy after a hip fracture? A prospective, multicentric cohort study. Arch Phys Med Rehabil 2018;99:893-9.
7. Pashikanti L, Von Ah D. Impact of early mobilization protocol on the medical-surgical inpatient population: An integrated review of literature. Clin Nurse Spec 2012;26:87-94.
8. Mehraj M, Khurana S, Joshi UR, Jain A, Kumar B, Prakash BB, et al. Early results of internal fixation with femoral neck system in young patients with femoral neck fracture. Ortop Traumatol Rehabil 2022;24:305-9.
9. Khoo C, Haseeb A, Ajit Singh V. Cannulated screw fixation for femoral neck fractures: A 5-year Experience in a single institution. Malays Orthop J 2014;8:14-21.
10. Carneiro MB, Alves DP, Mercadante MT. Physical therapy in the postoperative of proximal femur fracture in elderly. Literature review. Acta Ortop Bras 2013;21:175-8.
11. Strini V, Piazzetta N, Gallo A, Schiavolin R. Barthel index: Creation and validation of two cut-offs using the BRASS Index. Acta Biomed 2020;91:19-26.
12. Zhang YZ, Lin Y, Li C, Yue XJ, Li GY, Wang B, et al. A Comparative analysis of femoral neck system and three cannulated screws fixation in the treatment of femoral neck fractures: A six-month follow-up. Orthop Surg 2022;14:686-93.
13. Yang J, Zhou X, Li L, Xu L, Zhu W, Xu W, et al. Comparison of femoral neck system and inverted triangle cannulated screws fixations in treatment of Pauwels typle femoral neck fractures. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021;35:1111-8.
14. Yan C, Wang X, Xiang C, Jiang K, Li Y, Chen Q, et al. Comparison of effectiveness of femoral neck system and cannulate compression screw in treatment of femoral neck fracture in young and middle-aged patients. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021;35:1286-92.

How to Cite this article: Vatkar A, Kale S, Kanade G, Godke A, Dey JK, Godke R, Mehta N, Das S. Comparing the Efficiency of the Femoral Neck System and the Cannulated Compression Screw in Treating Femoral Neck Fractures in Patients Who Are Young and Middle-aged Indian Population. Journal of Clinical Orthopaedics 2023;8(2):16-20.

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