Outcomes of Osteosynthesis of non-displaced femoral neck fra
The purpose of this study was to evaluate the short-term clinical and radiological outcomes after non-displaced (Garden I and II) FNF osteosynthesis using TS, DHS, and FNS. Femoral neck fractures (FNF) are frequent in the elderly population, and surgical management is indicated in the vast majority of cases. Osteosynthesis is an alternative to arthroplasty for non-displaced FNF. Triple screw construct (TS) and the dynamic hip screw system: DHS are considered gold standards for osteosynthesis.

All the patients of the author’s institution aged more than 75 years with a non-displaced (Garden I and II) FNF eligible for osteosynthesis were included in this study. Patients were treated with either TS, DHS, or FNS depending on the surgeon’s preference. The radiological analysis assessed the fracture classification, fracture impaction, and proximal femur shortening at 3 and 6 months using the institutional imaging software.

--Baseline characteristics in the TS (n = 32), DHS (n = 16), and FNS (n = 15) groups were similar with respect to age (mean 85 years), gender (female to male ratio 4:1), and ASA score.

--There were no significant differences across the groups for the need for blood transfusion, surgical site complications, length of stay, postoperative medical complications and readmission within 30 days, discharge location, and mortality within 3 months.

--The duration of surgery was significantly lower in the FNS group.

--The radiological assessment found similar impaction (5.2 mm ± 4.8) and shortening (8.6 mm ± 8.2) in all groups that did not seem to progress after 3 months.

The FNS, in particular, looks to be a viable alternative implant for FNF osteosynthesis, with a shorter operational duration than the TS and DHS. FNS implants have similar short-term clinical and radiological outcomes to TS and DHS implants.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02622-z