Presenting Author Arjun K Reddy BA Coauthors Jake X Checketts DO Grayson R Norris BS Byron Detweiler DO Jay Thompson DO Chip Moore DO Mark Johnson DO Azad Dadgar DO Brent Norris MD ID: 917905
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Fixation of acute Femoral Neck Fractures with the Femoral Neck System (FNS) in comparison to Closed Reduction Percutaneous Pinning (CRPP). A short-term outcome and preliminary long-term study with 12 months of follow-up
Presenting Author: Arjun K. Reddy B.A.
Co-authors: Jake X.
Checketts
DO, Grayson R. Norris BS, Byron Detweiler DO, Jay Thompson DO, Chip Moore DO, Mark Johnson DO, Azad
Dadgar
DO, Brent Norris, MD
Slide2Conflicts of InterestNone to disclose
Slide3Introduction
Approximately 20 billion dollars are spent on the management of hip fractures, and it is estimated that 300,000 cases of hip fractures will happen yearly by 2030.
1-3
Hip fractures are seen mainly in the elderly population after ground-level falls, but can also occur in the young adult population after high energy trauma.
4,5
Slide4Introduction
Gold Standard for non-displaced Femoral Neck Fractures (Garden I & 2) internal fixation with Percutaneous Cannulated Screws
Dolatowski
et al. found that 20% of patients required major revision surgery compared to the 5% of patients that underwent hemiarthroplasty.
6
Slide5Purpose
Slide6Methods
Slide7Short-Term Outcomes
Complications
Post-operative pain was shown to be significantly reduced when using the FNS in comparison to CRPP
Short term re-operation rates were significantly reduced in the FNS group in comparison to the CRPP
Average Collapse was greater in the CRPP group in comparison to the FNS group
Slide8One-Year Outcomes
18 (40.0%) of the FNS patients were at least one year from surgery. Of these,
10 (55.6%) patients were available for one-year follow-up data.
Slide9One-Year Outcomes
Harris Hip Scores
Average Harris Hip Score = 93.3 (Range 77-100).
7 (70.0%) of patients received a Harris Hip Score of 90 or greater.
3 (30.0%) receiving a score of 100.
Slide10Radiographic Outcomes
We obtained patients radiographic outcomes on 9 (one patient denied further radiographic evaluation).
All 9 achieved radiographic union.
No patient had collapse of their fracture over the 20mm of controlled collapse the FNS allows.
The mean and median collapse measured was 3.74mm and 1.7mm, respectively (Range .1-15.3mm)
Slide11Conclusion
Slide12References1.
Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States.
JAMA
. 2009;302(14):1573-1579. doi:
10.1001/jama.2009.1462
2. Shimizu T, Miyamoto K, Masuda K, et al. The clinical significance of impaction at the femoral neck fracture site in the elderly. Arch Orthop Trauma Surg. 2007;127(7):515-521. doi:10.1007/s00402-007-0358-z3. Miyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Surgical Management of Hip Fractures: An Evidence-based Review of the Literature. I: Femoral Neck Fractures. Journal of the American Academy of Orthopaedic Surgeons. 2008;16(10):596-607. doi:10.5435/00124635-200810000-000054. Christodoulou NA, Dretakis EK. Significance of muscular disturbances in the localization of fractures of the proximal femur. Clin Orthop Relat Res. 1984;(187):215-217.
https://www.ncbi.nlm.nih.gov/pubmed/67447205. Ly TV, Swiontkowski MF. Management of femoral neck fractures in young adults. Indian J Orthop. 2008;42(1):3-12. doi:10.4103/0019-5413.385746. Dolatowski FC, Frihagen F, Bartels S, et al. Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial. J Bone Joint Surg Am. 2019;101(2):136-144. doi:10.2106/JBJS.18.00316